MEDICARE: THE NEMOURS FOUNDATION

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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1629591870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NEMOURS FOUNDATION

Provider Business Mailing Address
First Line	:	10140 CENTURION PKWY N
Second Line	:	C/O MANAGED CARE
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-0532
Country	:	US
Telephone Number	:	904-697-5628
Fax Number	:

Provider Business Practice Location Address
First Line	:	9368 NARCOOSSEE RD STE 105
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-5704
Country	:	US
Telephone Number	:	407-332-6113
Fax Number	:

Authorized Official
Title or Position	:	SR. VICE PRESIDENT AND CFO
Name	:	MR. RODNEY A MCKENDREE
Credential	:
Telephone Number	:	904-697-5648

Provider Enumeration Date	:	07/19/2017
Last Update Date	:	01/25/2024

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Directions to “THE NEMOURS FOUNDATION ” Practice Location

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