Organization
JAX ANESTHESIA PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK R GROOVER MD (CEO)
(904) 483-5850
Entity
Organization
Contact information
Practice address
4800 BELFORT RD, JACKSONVILLE, FL 32256-6004
(904) 483-5850
(904) 483-5860
Mailing address
4800 BELFORT RD, JACKSONVILLE, FL 32256-6004
(904) 483-5850
(904) 483-5960
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277552200
—
FL
Enumeration date
06/10/2006
Last updated
01/12/2010
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