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General NPI Number Information
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NPI Number | 1679726889
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Entity Type | Organization
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Legal Business Name | NEUROLOGY SPECIALISTS OF JACKSONVILLE PA
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Dates
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Enumeration Date | 10/31/2008
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | 3627 UNIVERSITY BLVD S SUITE 255
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4230
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Country | US
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Telephone | 904-396-4666
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Fax | 904-396-4777
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Provider Business Mailing Address
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Address Line | 13245 ATLANTIC BLVD SUITE 4-332
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City | JACKSONVILLE
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State | FL
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Zip | 32225-7121
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Country | US
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Telephone | 904-396-4666
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Fax | 904-396-4777
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MS. EILEEN E GROBLEWSKI
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Credential |
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Telephone | 904-514-9510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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