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General NPI Number Information
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NPI Number | 1184610420
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA OTOLARYNGOLOGY ASSOCIATES PA
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1801 BARRS ST SUITE 700
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4732
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Country | US
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Telephone | 904-387-3001
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Fax | 904-389-6627
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Provider Business Mailing Address
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Address Line | 1801 BARRS ST SUITE 700
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4732
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Country | US
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Telephone | 904-387-3001
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Fax | 904-389-6627
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CHERYL P LAUCKS
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Credential |
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Telephone | 904-389-6570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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