Organization
BRANCH MEDICAL CLINIC MAYPORT
Active
Parent organization
NAVAL HOSPITAL JACKSONVILLE
Organization subpart
Yes
Provider details
NPI number
Legal business name
NAVAL HOSPITAL JACKSONVILLE
Authorized official
WILLIAM M CONDON (BUMED UBO)
(240) 401-3643
Entity
Organization
Contact information
Practice address
2130 MAYPORT RD, JACKSONVILLE, FL 32233-2753
(904) 270-4446
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2017
Last updated
12/13/2017
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