Healthcare Provider Details

I. General information

NPI: 1679796395
Provider Name (Legal Business Name): ECG ASSOCIATES OF JACKSONVILLE P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 04/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PRUDENTIAL DR
JACKSONVILLE FL
32207-8202
US

IV. Provider business mailing address

PO BOX 47590
JACKSONVILLE FL
32247-7590
US

V. Phone/Fax

Practice location:
  • Phone: 904-202-2000
  • Fax:
Mailing address:
  • Phone: 904-396-5558
  • Fax: 904-396-4279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246W00000X
TaxonomyCardiology Technician
License Number
License Number State

VIII. Authorized Official

Name: JOEL SCHRANK
Title or Position: PRESIDENT
Credential:
Phone: 904-396-2342