Healthcare Provider Details

I. General information

NPI: 1659355725
Provider Name (Legal Business Name): MAYO CLINIC FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 SAN PABLO RD S
JACKSONVILLE FL
32224-1865
US

IV. Provider business mailing address

4500 SAN PABLO RD S
JACKSONVILLE FL
32224-1865
US

V. Phone/Fax

Practice location:
  • Phone: 904-296-5495
  • Fax:
Mailing address:
  • Phone: 904-296-5495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number103502
License Number StateFL

VIII. Authorized Official

Name: ALICE RIGDON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 904-953-0577