Healthcare Provider Details

I. General information

NPI: 1679144737
Provider Name (Legal Business Name): NORTH FLORIDA SURGEONS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 07/08/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7051 SOUTHPOINT PKWY S STE 300
JACKSONVILLE FL
32216-8713
US

IV. Provider business mailing address

11945 SAN JOSE BLVD STE 300
JACKSONVILLE FL
32223-1627
US

V. Phone/Fax

Practice location:
  • Phone: 904-398-2720
  • Fax: 904-398-6408
Mailing address:
  • Phone: 904-396-1725
  • Fax: 904-396-4893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN P. BERLIN
Title or Position: CEO
Credential:
Phone: 904-396-1725