SOUTHSIDE FAMILY PRACTICE &WOMENS HEALTH PA NPI 1326171190

NPI Information

SOUTHSIDE FAMILY PRACTICE &WOMENS HEALTH PA is a specialist in Jacksonville, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTHSIDE FAMILY PRACTICE &WOMENS HEALTH PA NPI is 1326171190. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8075 GATE PKWY W
SUITE 102&103
JACKSONVILLE, FL
ZIP 32216-684
Phone: (904) 296-1010
Fax: (904) 296-0393

The provider's authorized official is Suparna Gulani .
The authorized official title is Medical Director and has the following contact phone number (904) 296-1010.

The enumeration date for this NPI number is 3/13/2007 and was last updated on 12/4/2012.

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:

Other Identifiers

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

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