10D2156418 CLIA NUMBER - FLORIDA PHYSICIAN SPECIALISTS

Laboratory Demographics

CLIA Number: 10D2156418

Facility Name: FLORIDA PHYSICIAN SPECIALISTS

Facility Address:
6817 SOUTHPOINT PKWY STE 102
JACKSONVILLE, FL
ZIP 32216
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Facility Phone Number: 904 355-6583

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1912920372

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	10D2156418
LAB Type	Physician Office
Facility Name	FLORIDA PHYSICIAN SPECIALISTS
Street	6817 SOUTHPOINT PKWY STE 102
City	JACKSONVILLE
State	FL
ZIP	32216
Phone	904 355-6583
CertificateType	4
CertificateEffectiveDate	10/17/2022
CertificateExpirationDate	10/16/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024