Organization
ACE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH ELLYSON (OFFICE MANAGER)
(904) 475-2039
Entity
Organization
Contact information
Practice address
6428 BEACH BLVD, JACKSONVILLE, FL 32216-2813
(904) 475-2039
(904) 330-0668
Mailing address
6428 BEACH BLVD, JACKSONVILLE, FL 32216-2813
(904) 475-2039
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
213E00000X
Podiatrist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP1100X
Podiatric Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7635710004
NSC
—
Enumeration date
02/26/2013
Last updated
09/15/2025
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