Organization
UNIVERSITY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN DAMASCO (MANAGER)
(904) 367-8686
Entity
Organization
Contact information
Practice address
2535 UNIVERSITY BLVD W, JACKSONVILLE, FL 32217-2003
(904) 367-8686
Mailing address
PO BOX 56164, JACKSONVILLE, FL 32241-6164
(904) 367-8686
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
06776
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379300100
—
FL
Enumeration date
08/29/2009
Last updated
08/29/2009
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