Organization
NORTH FLORIDA OTOLARYNGOLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL P LAUCKS (OFFICE MANAGER)
(904) 389-6570
Entity
Organization
Contact information
Practice address
1801 BARRS ST, SUITE 700, JACKSONVILLE, FL 32204-4732
(904) 387-3001
(904) 389-6627
Mailing address
1801 BARRS ST, SUITE 700, JACKSONVILLE, FL 32204-4732
(904) 387-3001
(904) 389-6627
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00314
BS GRP NUMBER
FL
Enumeration date
09/22/2005
Last updated
08/22/2020
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