# JACKSONVILLE ORTHOPAEDIC INSTITUTE INC

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

## Provider details

- **NPI number:** 1609319607
- **Authorized official:** JOHN RICCHINI (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (904) 346-3465

## Contact information

- **Practice address:** 1348 S 18TH ST, SUITE 320B, FERNANDINA BEACH, FL 32034-4785
- **Practice address phone:** (904) 261-8787
- **Practice address fax:** (904) 261-9653
- **Mailing address:** PO BOX 117345, ATLANTA, GA 30368-7345
- **Mailing address phone:** (904) 346-3465
- **Mailing address fax:** (904) 858-6489

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | FL | Yes |

## Other

- **Enumeration date:** 11/22/2016
- **Last updated:** 01/24/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003151000 | — | FL |
| 01 | — | CC4257 | RR MEDICARE | FL |