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General NPI Number Information
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NPI Number | 1124050711
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Entity Type | Organization
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Legal Business Name | MEADOWLANDS MEDICAL CENTER, PA
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 1543 KINGSLEY AVE BLDG 1
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City | ORANGE PARK
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State | FL
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Zip | 32073-4535
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Country | US
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Telephone | 904-706-1636
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Fax | 904-592-1322
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Provider Business Mailing Address
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Address Line | 1871 SENTRY OAK CT
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-3775
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Country | US
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Telephone | 904-706-1636
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Fax | 904-592-1322
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MARC LOUIS ALESSANDRIA
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Credential | MD
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Telephone | 904-706-1636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME70009
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License Number State | FL
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