Healthcare Provider Details

I. General information

NPI: 1255296893
Provider Name (Legal Business Name): DRS CHOICE VASCULAR ACCESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 IRVINGTON AVE
JACKSONVILLE FL
32210-2014
US

IV. Provider business mailing address

4501 IRVINGTON AVE
JACKSONVILLE FL
32210-2014
US

V. Phone/Fax

Practice location:
  • Phone: 904-800-2375
  • Fax: 904-892-8181
Mailing address:
  • Phone: 904-800-2375
  • Fax: 904-892-8181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH I CONNELL
Title or Position: MEMBER
Credential:
Phone: 904-800-2375