IPS OF JACKSONVILLE LLC NPI 1417192022

NPI Information

NPI: 1417192022
Provider Name: IPS OF JACKSONVILLE LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
4754 E STATE ROAD 64
BRADENTON, FL
ZIP 34208
Phone: (888) 337-3509
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IPS OF JACKSONVILLE LLC is an ambulatory surgical clinic center in Bradenton, FL. IPS OF JACKSONVILLE LLC NPI is 1417192022. The provider is registered as an organization entity type.

The provider's business location address is:

4754 E STATE ROAD 64
BRADENTON, FL
ZIP 34208-058
Phone: (888) 337-3509
Fax: (941) 328-3997

The provider's authorized official is Carl R Noback .
The authorized official title is Member and has the following contact phone number (941) 360-1566.

The enumeration date for this NPI number is 12/10/2008 and was last updated on 1/10/2017.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	1176	FLORIDA	Yes

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

NPI Synchronization or Removal

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