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DOCTORS INLET PEDIATRICS & PRIMARY CARE PA NPI 1205039690


NPI Information

NPI: 1205039690
Provider Name: DOCTORS INLET PEDIATRICS & PRIMARY CARE, PA
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
10175 FORTUNE PKWY UNIT 401
JACKSONVILLE, FL
ZIP 32256
Phone: (904) 298-1994
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DOCTORS INLET PEDIATRICS & PRIMARY CARE, PA is an internal medicine in Jacksonville, FL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. DOCTORS INLET PEDIATRICS & PRIMARY CARE, PA NPI is 1205039690. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10175 FORTUNE PKWY UNIT 401
JACKSONVILLE, FL
ZIP 32256
Phone: (904) 298-1994
Fax: (904) 298-1973

The provider's authorized official is Milind V Tilak .
The authorized official title is Owner and has the following contact phone number (904) 298-1994.

The enumeration date for this NPI number is 6/6/2007 and was last updated on 7/31/2018.


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
1207QA0505XFamily MedicineAdult MedicineNo
2208VP0014XPain MedicineInterventional Pain MedicineNo
3207R00000XInternal MedicineYes

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
1265248001MEDICAIDFLORIDA

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: 11/14/2023

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