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General NPI Number Information
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NPI Number | 1912962101
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Entity Type | Organization
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Legal Business Name | MAYO CLINIC FLORIDA
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 4500 SAN PABLO RD S
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City | JACKSONVILLE
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State | FL
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Zip | 32224-1865
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Country | US
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Telephone | 904-953-2000
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Fax | 904-953-1768
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Provider Business Mailing Address
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Address Line | 4500 SAN PABLO RD S
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City | JACKSONVILLE
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State | FL
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Zip | 32224-1865
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Country | US
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Telephone | 904-953-2000
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Fax | 904-953-1768
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Authorized Official
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Title or Position | CFO
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Name | MRS. MARY J HOFFMAN
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Credential |
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Telephone | 904-953-7395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 4438
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License Number State | FL
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