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General NPI Number Information
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NPI Number | 1477452381
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Entity Type | Organization
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Legal Business Name | RIVERCITY CARDIOLOGY OF JAX
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 10306 SILVERBROOK TRL
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City | JACKSONVILLE
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State | FL
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Zip | 32256-5864
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Country | US
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Telephone | 904-962-6005
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Fax |
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Provider Business Mailing Address
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Address Line | 10306 SILVERBROOK TRL
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City | JACKSONVILLE
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State | FL
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Zip | 32256-5864
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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 | ADMIN
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Name | HAISSAM BARAKAT
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Credential |
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Telephone | 904-962-6005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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