# ST VINCENT'S FULL SERVICE URGENT CARE, LLC

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

## Provider details

- **NPI number:** 1750672051
- **Authorized official:** ANDREA MENDOZA (CHIEF REV. CYCLE SPECIALIST)
- **Authorized official phone:** (904) 450-6045

## Contact information

- **Practice address:** 10503 SAN JOSE BLVD, JACKSONVILLE, FL 32257
- **Practice address phone:** (904) 379-1203
- **Practice address fax:** (904) 379-9282
- **Mailing address:** 4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | — |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/21/2011
- **Last updated:** 07/23/2018