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Organization
ST. VINCENT'S FIRST CARE
Active
Organization
ST. VINCENT'S FIRST CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK REDDINGER (CHIEF FINANCIAL OFFICER)
(904) 738-5177
Entity
Organization
Contact information
Practice address
5501 ROOSEVELT BLVD, JACKSONVILLE, FL 32244-2345
(904) 379-1203
(904) 379-9282
Mailing address
8323 RAMONA BLVD W, JACKSONVILLE, FL 32221-1386
(904) 379-1203
(904) 379-9282
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
EXEMPT HOSPITAL OWNE
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007293401
—
FL
05
—
007294300
—
FL
01
—
040J
BLUE CROSS FLORIDA
FL
Enumeration date
12/10/2013
Last updated
12/10/2013
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