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NPI Code Detail

MEDICARE: NORTH FLORIDA SURGEONS BPCI-A, LLC

MEDICARE: NORTH FLORIDA SURGEONS BPCI-A, LLC
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
1207X00000XOrthopaedic Surgery Physician
2207XS0117XOrthopaedic Surgery of the Spine Physician
3208C00000XColon & Rectal Surgery Physician
4208600000XSurgery Physician

General Provider Information

NPI Number : 1578254389
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH FLORIDA SURGEONS BPCI-A, LLC
Provider Business Mailing Address
First Line : 11945 SAN JOSE BLVD STE 300
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32223-1627
Country : US
Telephone Number : 904-396-1725
Fax Number : 904-396-4893
Provider Business Practice Location Address
First Line : 4910 BEACH BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-4817
Country : US
Telephone Number : 904-399-0667
Fax Number : 904-399-3330
Authorized Official
Title or Position : CEO
Name : JOHN BERLIN
Credential :
Telephone Number : 904-396-1725
Provider Enumeration Date : 05/15/2023
Last Update Date : 05/15/2023

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