Organization
COGENT HEALTHCARE OF JACKSONVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA FALL (MANAGER)
(253) 682-6040
Entity
Organization
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-3850
(904) 244-4799
Mailing address
5410 MARYLAND WAY, SUITE 300, BRENTWOOD, TN 37027-5064
(615) 377-5600
(888) 241-1404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001651500
—
FL
01
—
00A4D
BLUE CROSS/BLUE SHIELD OF FLORIDA
FL
Enumeration date
05/04/2009
Last updated
03/07/2025
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