Organization
NOVOCARDIA JACKSONVILLE ASC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN BLUMENTHAL MD (OWNER)
(617) 694-1113
Entity
Organization
Contact information
Practice address
153 FORT WADES ROAD, PONTE VEDRA, FL 32081
(904) 423-0010
Mailing address
PO BOX 47170, JACKSONVILLE, FL 32247-7170
(904) 423-0010
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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