MEDICARE: NORTH FLORIDA SURGEONS, PA

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	261QP2000X	Physical Therapy Clinic/Center
2	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1639977903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH FLORIDA SURGEONS, PA

Provider Business Mailing Address
First Line	:	11945 SAN JOSE BLVD STE 300
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-1627
Country	:	US
Telephone Number	:	904-396-1725
Fax Number	:	904-396-4893

Provider Business Practice Location Address
First Line	:	42 BUSINESS CENTRE DR UNIT 310
Second Line	:
City	:	MIRAMAR BEACH
State	:	FL
Zip	:	32550-6995
Country	:	US
Telephone Number	:	850-353-2719
Fax Number	:	866-939-1350

Authorized Official
Title or Position	:	CEO
Name	:	JOHN P. BERLIN
Credential	:
Telephone Number	:	904-396-1725

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	03/04/2025

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