MEDICARE: DR. PHILIPPOS D KARTSONIS MD

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	ME87647	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00076280	OTHER	FL	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1376515791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIPPOS D KARTSONIS MD

Provider Business Mailing Address
First Line	:	6817 SOUTHPOINT PKWY
Second Line	:	1404
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6282
Country	:	US
Telephone Number	:	904-322-8844
Fax Number	:

Provider Business Practice Location Address
First Line	:	6817 SOUTHPOINT PKWY
Second Line	:	1404
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6282
Country	:	US
Telephone Number	:	904-322-8844
Fax Number	:

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	10/16/2025

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