# FIRST COAST MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134157217
- **Authorized official:** DIANA WHEELER (OFFICE MANAGER)
- **Authorized official phone:** (904) 723-5665

## Contact information

- **Practice address:** 4211 N PEARL ST, JACKSONVILLE, FL 32206-6411
- **Practice address phone:** (904) 358-8692
- **Practice address fax:** (904) 354-6908
- **Mailing address:** PO BOX 17809, JACKSONVILLE, FL 32245-7809
- **Mailing address phone:** (904) 723-0015
- **Mailing address fax:** (904) 338-0951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | Yes |
| 111N00000X | Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 06/29/2006
- **Last updated:** 02/07/2014