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General NPI Number Information
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NPI Number | 1649039074
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Entity Type | Organization
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Legal Business Name | JACKSONVILLE PREMIER ORTHOPEDICS LLC
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 6067 KENNERLY RD
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4305
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Country | US
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Telephone | 904-731-3131
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Fax |
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Provider Business Mailing Address
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Address Line | 11222 STRATEGY CT
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City | JACKSONVILLE
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State | FL
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Zip | 32256-4091
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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 | PRESIDENT
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Name | DR. RALPH RIZK
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Credential | MD
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Telephone | 904-731-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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