MEDICARE: RONALD NORTH CAP

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1295223600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD NORTH CAP

Provider Business Mailing Address
First Line	:	4427 EMERSON ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-4969
Country	:	US
Telephone Number	:	904-398-0837
Fax Number	:	904-346-0837

Provider Business Practice Location Address
First Line	:	4427 EMERSON ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-4969
Country	:	US
Telephone Number	:	904-398-0837
Fax Number	:	904-346-0837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2018
Last Update Date	:	05/01/2018

Similar Medicare Providers

1497702625 — JOAN B LEHMANN MD
Practice Location Address:

4427 EMERSON ST
JACKSONVILLE, FL
32207-4969

Practice Phone: 904-398-7015
Practice Fax:

1952679136 — MICHAEL J FARLESS PA-C
Practice Location Address:

4427 EMERSON ST. #4
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32207-4969

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Practice Fax:

1649768037 — TIFFANY ANGELA YARBOUGH
Practice Location Address:

4427 EMERSON ST # 4308
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Practice Fax:

1619465093 — MRS. VANETTA K SINCLAIR BS,CAP
Practice Location Address:

4427 EMERSON ST
JACKSONVILLE, FL
32207-4969

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Practice Fax:

1275021651 — KENDRA GRAY LEE
Practice Location Address:

4427 EMERSON ST
JACKSONVILLE, FL
32207-4969

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1689162091 — ALICIA RENEE REYNOLDS
Practice Location Address:

4427 EMERSON ST
JACKSONVILLE, FL
32207-4969

Practice Phone: 904-398-7015
Practice Fax: 904-346-0837

Directions to “ RONALD NORTH CAP” Practice Location

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