# THE DOCTORS CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** THE DOCTORS CENTER PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053366880
- **Authorized official:** DAVID ROMANELLO (COO)
- **Authorized official phone:** (352) 459-3661

## Contact information

- **Practice address:** 9857 OLD SAINT AUGUSTINE RD STE 1, JACKSONVILLE, FL 32257-8821
- **Practice address phone:** (904) 861-1900
- **Practice address fax:** (904) 292-9684
- **Mailing address:** 9857 OLD SAINT AUGUSTINE RD STE 1, JACKSONVILLE, FL 32257-8821
- **Mailing address phone:** (904) 861-1900
- **Mailing address fax:** (904) 292-9684

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 05/23/2006
- **Last updated:** 09/20/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1018488 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 01 | — | 39739 | BLUE CROSS BLUE SHIELD | FL |