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Organization
JACKSONVILLE HEALTH CLINIC PA
Active
Organization
JACKSONVILLE HEALTH CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOUJANYA SANGAM MD (OWNER)
(904) 726-1797
Entity
Organization
Contact information
Practice address
2030 SOUTHSIDE BOULEVARD, SUITE C, JACKSONVILLE, FL 32216
(904) 726-1797
(904) 726-1798
Mailing address
P O BOX 16486, JACKSONVILLE, FL 32246-6486
(904) 726-1797
(904) 726-1798
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/18/2006
Last updated
08/22/2020
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