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General NPI Number Information
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NPI Number | 1962895326
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS INC
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Dates
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Enumeration Date | 03/10/2015
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 15255 MAX LEGGETT PKWY STE 4600 UFJP - UF HEALTH BIRTH CENTER
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City | JACKSONVILLE
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State | FL
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Zip | 32218-7213
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Country | US
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Telephone | 904-427-6378
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Fax | 904-383-1410
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Provider Business Mailing Address
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Address Line | PO BOX 44008 UFJP - PROVIDER ENROLLMENT
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City | JACKSONVILLE
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State | FL
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Zip | 32231-4008
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Country | US
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Telephone | 904-244-3199
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Fax | 904-244-3425
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Authorized Official
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Title or Position | DIRECTOR
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Name | WENDEY C LANDKROHN
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Credential |
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Telephone | 904-244-3603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 352
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License Number State | FL
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