Organization
ST VINCENTS MEDICAL CENTER INC
Active
Other names
St Vincents Medical Center Riverside, Ascension St. Vincent's Riverside
Organization subpart
No
Provider details
NPI number
Authorized official
COBA SUSAN CORNEJO (CHIEF OPERATING OFFICER)
(850) 416-6206
Entity
Organization
Contact information
Practice address
1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204-4748
(904) 308-7300
Mailing address
4205 BELFORT ROAD, JAB # 4020, JACKSONVILLE, FL 32216-1475
(904) 450-6020
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
4376
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010073100
—
FL
01
—
108
BCBS
FL
Enumeration date
10/10/2005
Last updated
03/17/2026
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