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Organization
JACKSONVILLE SPINE CENTER PA
Active
Organization
JACKSONVILLE SPINE CENTER PA
Active
Other names
Jax Spine & Pain Centers
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA M GROTH (CREDENTIALING SPECIALIST)
(904) 223-3321
Entity
Organization
Contact information
Practice address
5191 FIRST COAST TECH PKWY, JACKSONVILLE, FL 32224
(904) 223-3321
(904) 223-2169
Mailing address
5191 FIRST COAST TECH PKWY, 3RD FLOOR, JACKSONVILLE, FL 32224
(904) 223-3321
(904) 223-2169
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
05/09/2006
Last updated
05/09/2023
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