MEDICAL DIAGNOSTIC CENTER OF JACKSONVILLE NPI 1164592218

NPI Information

NPI: 1164592218
Provider Name: MEDICAL DIAGNOSTIC CENTER OF JACKSONVILLE
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
1400 BISHOP ESTATES RD
JACKSONVILLE, FL
ZIP 32259
Phone: (904) 287-6263
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MEDICAL DIAGNOSTIC CENTER OF JACKSONVILLE is a diagnostic radiology radiology in Jacksonville, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MEDICAL DIAGNOSTIC CENTER OF JACKSONVILLE NPI is 1164592218. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1400 BISHOP ESTATES RD
JACKSONVILLE, FL
ZIP 32259-244
Phone: (904) 287-6263
Fax: (904) 287-6213

The provider's authorized official is Nicolau Sacaquini .
The authorized official title is Business Director and has the following contact phone number (904) 731-1556.

The enumeration date for this NPI number is 11/8/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	HCC5331	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	V2764	OTHER	FLORIDA	BCBS PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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