MEDICARE: JACKSONVILLE MULTISPECIALTY GROUP, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	208M00000X	Hospitalist Physician
2	207Q00000X	Family Medicine Physician	FL
3	207RI0200X	Infectious Disease Physician	FL
4	207R00000X	Internal Medicine Physician	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	:	1609951938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACKSONVILLE MULTISPECIALTY GROUP, LLC

Provider Business Mailing Address
First Line	:	PO BOX 17577
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32245-7577
Country	:	US
Telephone Number	:	904-399-1623
Fax Number	:	904-399-1624

Provider Business Practice Location Address
First Line	:	3627 UNIVERSITY BLVD S STE 615
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-7401
Country	:	US
Telephone Number	:	904-399-1623
Fax Number	:	904-399-1624

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HERNAN ROBERT CHANG
Credential	:	M.D.
Telephone Number	:	904-399-1623

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	11/15/2025

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Directions to “JACKSONVILLE MULTISPECIALTY GROUP, LLC ” Practice Location

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