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NPI Code Detail

MEDICARE: JACKSONVILLE ANESTHESIA CORPORATION INC

MEDICARE: JACKSONVILLE ANESTHESIA CORPORATION INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033163738
Entity Type Code : Organization
Provider Name (Legal Business Name) : JACKSONVILLE ANESTHESIA CORPORATION INC
Provider Business Mailing Address
First Line : PO BOX 160489
Second Line :
City : MIAMI
State : FL
Zip : 33116-0489
Country : US
Telephone Number : 855-496-3578
Fax Number : 855-371-8490
Provider Business Practice Location Address
First Line : 1350 13TH AVE S
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32250-3203
Country : US
Telephone Number : 855-496-3578
Fax Number : 855-371-8490
Authorized Official
Title or Position : PRESIDENT
Name : CHERYL LYNN DIXON
Credential : M.D.
Telephone Number : 904-238-4147
Provider Enumeration Date : 05/19/2006
Last Update Date : 02/02/2017

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Directions to “JACKSONVILLE ANESTHESIA CORPORATION INC ” Practice Location

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