Healthcare Provider Details

I. General information

NPI: 1215880190
Provider Name (Legal Business Name): FITZONE MEDICAL CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2064 PARK ST
JACKSONVILLE FL
32204-3810
US

IV. Provider business mailing address

2064 PARK ST
JACKSONVILLE FL
32204-3810
US

V. Phone/Fax

Practice location:
  • Phone: 904-515-3570
  • Fax: 904-372-6068
Mailing address:
  • Phone: 904-515-3570
  • Fax: 904-372-6068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN B FITZMEYER
Title or Position: CEO
Credential: MD
Phone: 904-515-3570