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BORLAND GROOVER CLINIC PA NPI 1881644912


NPI Information

NPI: 1881644912
Provider Name: BORLAND GROOVER CLINIC, PA
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 10D1069049

Address:
4800 BELFORT RD
JACKSONVILLE, FL
ZIP 32256
Phone: (904) 398-7205
Get Directions

BORLAND GROOVER CLINIC, PA is a gastroenterology internal medicine in Jacksonville, FL. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. BORLAND GROOVER CLINIC, PA NPI is 1881644912. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4800 BELFORT RD
JACKSONVILLE, FL
ZIP 32256-004
Phone: (904) 398-7205
Fax: (904) 265-6409

The provider's authorized official is Kyle Etzkorn .
The authorized official title is Executive Vp Of Operations and has the following contact phone number (904) 398-7205.

The CLIA number assigned to this NPI record is 10D1069049 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/11/2006 and was last updated on 6/24/2015.


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
1207KA0200XAllergy & ImmunologyAllergyNo
2207ZP0102XPathologyAnatomic Pathology & Clinical PathologyNo
32080P0206XPediatricsPediatric GastroenterologyNo
42085R0202XRadiologyDiagnostic RadiologyNo
5208C00000XColon & Rectal SurgeryNo
6207RG0100XInternal MedicineGastroenterologyYes

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
199187MEDICARE PINFLORIDA
2060148900MEDICAIDFLORIDA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.