MEDICARE: UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RB0002X	Obesity Medicine (Internal Medicine) Physician
2	2080P0206X	Pediatric Gastroenterology Physician
3	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1730349002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS INC

Provider Business Mailing Address
First Line	:	PO BOX 44008
Second Line	:	UFJP PROVIDER ENROLLMENT
City	:	JACKSONVILLE
State	:	FL
Zip	:	32231-4008
Country	:	US
Telephone Number	:	904-244-3660
Fax Number	:

Provider Business Practice Location Address
First Line	:	655 W 8TH ST
Second Line	:	UFJP GASTROENTEROLOGY
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-6511
Country	:	US
Telephone Number	:	904-244-3660
Fax Number	:

Authorized Official
Title or Position	:	CEO/VICE PRESIDENT
Name	:	GUY I BENRUBI
Credential	:
Telephone Number	:	904-244-3109

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	06/11/2008

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