Healthcare Provider Details

I. General information

NPI: 1114912136
Provider Name (Legal Business Name): JACKSONVILLE EMERGENCY CONSULTANTS,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 06/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 CAPITAL MEDICAL BLVD
TALLAHASSEE FL
32308-4402
US

IV. Provider business mailing address

PO BOX 860554
ORLANDO FL
32886-0554
US

V. Phone/Fax

Practice location:
  • Phone: 850-656-5090
  • Fax:
Mailing address:
  • Phone: 904-641-6628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAY GYARMATHY
Title or Position: PRESIDENT
Credential: MD
Phone: 904-641-6628