Organization
SLRC JACKSONVILLE LLC
Active
Organization
SLRC JACKSONVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN LOMONICO (PRESIDENT)
(727) 418-2567
Entity
Organization
Contact information
Practice address
14286 BEACH BLVD STE 118, JACKSONVILLE, FL 32250-1561
(727) 418-2567
Mailing address
5425 BEAUMONT CENTER BLVD STE 918, TAMPA, FL 33634-5214
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
—
—
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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