MEDICARE: UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207QA0000X	Adolescent Medicine (Family Medicine) Physician
2	207QA0505X	Adult Medicine Physician
3	207QG0300X	Geriatric Medicine (Family Medicine) Physician
4	207RG0300X	Geriatric Medicine (Internal Medicine) Physician
5	208000000X	Pediatrics Physician
6	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1518126168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 44008
Second Line	:	UFJP PROVIDER ENROLLMENT
City	:	JACKSONVILLE
State	:	FL
Zip	:	32231-4008
Country	:	US
Telephone Number	:	904-244-3660
Fax Number	:

Provider Business Practice Location Address
First Line	:	851042 US HIGHWAY 17
Second Line	:	UFJP YULEE FAMILY PRACTICE
City	:	YULEE
State	:	FL
Zip	:	32097-2845
Country	:	US
Telephone Number	:	904-633-0670
Fax Number	:

Authorized Official
Title or Position	:	CEO/VICE PRESIDENT
Name	:	GUY I. BENRUBI
Credential	:
Telephone Number	:	904-244-3109

Provider Enumeration Date	:	06/07/2008
Last Update Date	:	06/07/2008

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Directions to “UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC. ” Practice Location

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