Organization
HCR MANOR CARE SERVICES OF FLORIDA, LLC
Active
Other names
ProMedica Hospice (Jacksonville)
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN DAVID ALLEN (SOLE DIRECTOR)
(419) 252-5734
Entity
Organization
Contact information
Practice address
8130 BAYMEADOWS WAY W STE 201, JACKSONVILLE, FL 32256-7451
(904) 737-2553
Mailing address
PO BOX 10086, TOLEDO, OH 43699-0086
(567) 585-1191
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001418-00
—
FL
Enumeration date
04/19/2022
Last updated
04/19/2022
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