Healthcare Provider Details

I. General information

NPI: 1023947025
Provider Name (Legal Business Name): UF HEALTH JACKSONVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 W 8TH ST
JACKSONVILLE FL
32209-6511
US

IV. Provider business mailing address

3460 BEACH BLVD APT 2406
JACKSONVILLE FL
32207-2374
US

V. Phone/Fax

Practice location:
  • Phone: 904-244-0411
  • Fax:
Mailing address:
  • Phone: 904-244-0411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES PLUMBACK IV
Title or Position: PHARMACY STUDENT
Credential:
Phone: 336-257-8798