Organization
FIRST COAST ORTHOPEDIC ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAISSAM BARAKAT (CREDENTIALING)
(904) 962-6005
Entity
Organization
Contact information
Practice address
6067 KENNERLY RD, JACKSONVILLE, FL 32216-4305
(904) 731-3131
Mailing address
3701 WINDMOOR DR, JACKSONVILLE, FL 32217-4240
(904) 388-4712
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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