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PHYSICIANS GROUP SERVICES PA NPI 1467616169


NPI Information

NPI: 1467616169
Provider Name: PHYSICIANS GROUP SERVICES PA

Doing Business As: FAMILY MEDICAL CENTER SAN PABLO

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D0880372

Address:
14011 BEACH BLVD
SUITE 120
JACKSONVILLE, FL
ZIP 32250
Phone: (904) 223-6400
Get Directions

PHYSICIANS GROUP SERVICES PA is a family medicine in Jacksonville, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PHYSICIANS GROUP SERVICES PA NPI is 1467616169. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Family Medical Center San Pablo.

The provider's business location address is:

14011 BEACH BLVD
SUITE 120
JACKSONVILLE, FL
ZIP 32250-507
Phone: (904) 223-6400
Fax: (904) 223-6420

The provider's authorized official is Andrew T Christman .
The authorized official title is Ceo and has the following contact phone number (941) 685-7688.

The CLIA number assigned to this NPI record is 10D0880372 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/11/2008 and was last updated on 4/26/2024.


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
1207Q00000XFamily MedicineYes
2363LF0000XNurse PractitionerFamilyNo
3364SP0200XClinical Nurse SpecialistPediatricsNo

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
1259123502MEDICAIDFLORIDA

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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