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Organization
BRANCH MEDICAL CLINIC MAYPORT
Active
Organization
BRANCH MEDICAL CLINIC MAYPORT
Active
Parent organization
NAVAL HOSPITAL JACKSONVILLE
Organization subpart
Yes
Provider details
NPI number
Legal business name
NAVAL HOSPITAL JACKSONVILLE
Authorized official
WILLIAM M CONDON (BUMED UBO)
(240) 401-3643
Entity
Organization
Contact information
Practice address
2130 MAYPORT RD, JACKSONVILLE, FL 32233-2753
(904) 270-4446
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2017
Last updated
12/13/2017
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