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General NPI Number Information
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NPI Number | 1083576045
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Entity Type | Individual
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Provider Name | ADAM ALEXANDER BIRCH
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Gender | Male
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Dates
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Enumeration Date | 11/28/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 2080 CHILD ST
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City | JACKSONVILLE
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State | FL
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Zip | 32214-5005
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Country | US
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Telephone | 904-546-7094
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Fax |
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Provider Business Mailing Address
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Address Line | 10667 BRIGHTMAN BLVD APT 7106
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City | JACKSONVILLE
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State | FL
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Zip | 32246-7528
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9121130
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License Number State | FL
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