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ST VINCENTS AMBULATORY CARE INC NPI 1417987124


NPI Information

NPI: 1417987124
Provider Name: ST VINCENTS AMBULATORY CARE INC
Classification: Neurological Surgery - 207T00000X
Entity Type: Organization
Address:
2 SHIRCLIFF WAY
SUITE 600
JACKSONVILLE, FL
ZIP 32204
Phone: (904) 308-6769
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ST VINCENTS AMBULATORY CARE INC is a neurological surgery in Jacksonville, FL. The provider is a neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. ST VINCENTS AMBULATORY CARE INC NPI is 1417987124. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2 SHIRCLIFF WAY
SUITE 600
JACKSONVILLE, FL
ZIP 32204-742
Phone: (904) 308-6769
Fax: (904) 308-4072

The provider's authorized official is Miranda Hemm .
The authorized official title is Enrollment Manager and has the following contact phone number (904) 450-6004.

The enumeration date for this NPI number is 7/5/2006 and was last updated on 10/17/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineFLORIDANo
2207RC0000XInternal MedicineCardiovascular DiseaseNo
3207RC0001XInternal MedicineClinical Cardiac ElectrophysiologyNo
4207RC0001XInternal MedicineClinical Cardiac ElectrophysiologyFLORIDANo
5207RP1001XInternal MedicinePulmonary DiseaseFLORIDANo
6207T00000XNeurological SurgeryFLORIDANo
7207V00000XObstetrics & GynecologyFLORIDANo
8208600000XSurgeryFLORIDANo
92086S0129XSurgeryVascular SurgeryFLORIDANo
10207T00000XNeurological SurgeryYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1276587000MEDICAIDFLORIDA

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

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