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General NPI Number Information
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NPI Number | 1205966090
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Entity Type | Organization
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Legal Business Name | WOMENS PHYSICIANS OF JACKSONVILLE PA
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 6879 SOUTHPOINT DR N
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6179
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Country | US
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Telephone | 904-296-2441
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Fax | 904-821-3113
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Provider Business Mailing Address
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Address Line | 6879 SOUTHPOINT DR N
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6179
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Country | US
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Telephone | 904-296-2441
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Fax | 904-821-3113
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LORRAINE RODRIGUEZ
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Credential | M.D.
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Telephone | 904-296-2441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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