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General NPI Number Information
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NPI Number | 1003912296
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Entity Type | Organization
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Legal Business Name | JACKSONVILLE ORTHOPAEDIC INSTITUTE INC
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 5737 BARNHILL DR SUITE 102
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City | JACKSONVILLE
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State | FL
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Zip | 32207-7189
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Country | US
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Telephone | 904-739-3319
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Fax | 904-448-1416
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Provider Business Mailing Address
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Address Line | PO BOX 117345
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City | ATLANTA
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State | GA
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Zip | 30368-7345
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Country | US
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Telephone | 904-346-3465
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Fax | 904-858-6490
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JOHN J RICCHINI
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Credential |
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Telephone | 904-346-3465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | FL
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