Organization
SAN JOSE CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTOINE KASSIS M.D. (MEDICAL DIRECTOR)
(904) 256-3330
Entity
Organization
Contact information
Practice address
2449 UNIVERSITY BLVD W, JACKSONVILLE, FL 32217-2037
(904) 256-3330
(904) 256-3332
Mailing address
504 BASSWOOD CT, JACKSONVILLE, FL 32259-4436
(904) 256-3330
(904) 256-3332
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME75962
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124628400
—
FL
Enumeration date
08/19/2009
Last updated
02/06/2025
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