Healthcare Provider Details

I. General information

NPI: 1396294146
Provider Name (Legal Business Name): POST ACUTE CARE SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2016
Last Update Date: 09/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6817 SOUTHPOINT PKWY SUITE 502
JACKSONVILLE FL
32216-6282
US

IV. Provider business mailing address

PO BOX 550587
JACKSONVILLE FL
32255-0587
US

V. Phone/Fax

Practice location:
  • Phone: 904-646-9267
  • Fax: 904-646-1501
Mailing address:
  • Phone: 904-646-9267
  • Fax: 904-646-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME107219
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME107219
License Number StateFL

VIII. Authorized Official

Name: DALIA ELRAMADY
Title or Position: OWNER
Credential: MD
Phone: 904-646-9267