MEDICARE: HELP4JAX INJURY CENTER

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	111N00000X	Chiropractor	266621	FL

General Provider Information

NPI Number	:	1487008124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELP4JAX INJURY CENTER

Provider Business Mailing Address
First Line	:	6820 SAINT AUGUSTINE RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2818
Country	:	US
Telephone Number	:	904-425-4546
Fax Number	:	904-425-4548

Provider Business Practice Location Address
First Line	:	6820 SAINT AUGUSTINE RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2818
Country	:	US
Telephone Number	:	904-425-4546
Fax Number	:	904-425-4548

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. PAMELA JEAN MOBARAK
Credential	:
Telephone Number	:	904-425-4546

Provider Enumeration Date	:	04/19/2016
Last Update Date	:	04/19/2016

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