Mayo Clinic Jacksonville

LBN: Mayo Clinic Jacksonville
Mayo Clinic Jacksonville is an health care organization with primary practice located at 4500 San Pablo Road , Jacksonville FL 32224-1865. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Multi-Specialty, Suppliers / Durable Medical Equipment & Medical Supplies. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty. Mayo Clinic Jacksonville can be contacted via phone (904) 953-1768, or through Rigdon, Alice via phone (904) 953-0577.

Contact Information

Primary practice address
4500 San Pablo Road Jacksonville FL 32224-1865
Phone: (904) 953-1768
Fax: (904) 953-1768
Website:
Map and Directions
Authorized official contact:
Name: Rigdon, Alice
Phone: (904) 953-0577

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1790772317
LBN Legal business name Mayo Clinic Jacksonville
DBA Doing business as
Authorized official Rigdon, Alice
Entity Organization
Organization subpart 1 No
Enumeration date Sep 29th, 2005
Last updated Apr 12th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790772317 NPPES
Florida MEDICAID 064350500
Florida MEDICAID 064350501
Florida MEDICAID 064350503

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