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NPI Code Detail

MEDICARE: FIRST COAST INFECTIOUS DISEASE CONSULTANTS LLC

MEDICARE: FIRST COAST INFECTIOUS DISEASE CONSULTANTS LLC
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
1207RC0200XCritical Care Medicine (Internal Medicine) Physician
2207RP1001XPulmonary Disease Physician
3207RI0200XInfectious Disease PhysicianME89939FL
4207RI0200XInfectious Disease Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740477843
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIRST COAST INFECTIOUS DISEASE CONSULTANTS LLC
Provider Business Mailing Address
First Line : PO BOX 16488
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32245-6488
Country : US
Telephone Number : 904-398-5614
Fax Number : 904-398-5617
Provider Business Practice Location Address
First Line : 2122 UNIVERSITY BLVD S
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-8937
Country : US
Telephone Number : 904-398-5614
Fax Number : 904-398-5617
Authorized Official
Title or Position : CEO
Name : BRIDGET ROBERTS
Credential :
Telephone Number : 904-398-5614
Provider Enumeration Date : 10/02/2007
Last Update Date : 10/13/2025

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Directions to “FIRST COAST INFECTIOUS DISEASE CONSULTANTS LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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