MEDICARE: WEST JAX PRIMARY CARE, P.A.

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
1	207Q00000X	Family Medicine Physician		FL

General Provider Information

NPI Number	:	1124134051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST JAX PRIMARY CARE, P.A.

Provider Business Mailing Address
First Line	:	7016 NORMANDY BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-6206
Country	:	US
Telephone Number	:	904-783-2405
Fax Number	:	904-781-6080

Provider Business Practice Location Address
First Line	:	7016 NORMANDY BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-6206
Country	:	US
Telephone Number	:	904-783-2405
Fax Number	:	904-781-6080

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GERALD GIURATO
Credential	:	M.D.
Telephone Number	:	904-783-2405

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	08/22/2020

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