MEDICARE: JACKSONVILLE SURGERY CENTER, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	AHCA1028	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134182546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACKSONVILLE SURGERY CENTER, LTD

Provider Business Mailing Address
First Line	:	7021 A C SKINNER PKWY
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-6932
Country	:	US
Telephone Number	:	904-281-0021
Fax Number	:	904-281-0988

Provider Business Practice Location Address
First Line	:	7021 A C SKINNER PKWY
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-6932
Country	:	US
Telephone Number	:	904-281-0021
Fax Number	:	904-281-0988

Authorized Official
Title or Position	:	VP/CFO
Name	:	DAVID MCKNIGHT
Credential	:
Telephone Number	:	972-789-2816

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	06/10/2026

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Directions to “JACKSONVILLE SURGERY CENTER, LTD ” Practice Location

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