Organization
BEACHSIDE PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBORAH GHANDOUR PA-C, DHSC (PRESIDENT)
(904) 595-5826
Entity
Organization
Contact information
Practice address
1825 3RD ST N STE B, JACKSONVILLE BEACH, FL 32250-4840
(904) 595-5826
(904) 595-5827
Mailing address
1825 3RD ST N STE B, JACKSONVILLE BEACH, FL 32250-4840
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/01/2022
Last updated
12/16/2022
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