Organization
IM SULZBACHER CENTER FOR THE HOMELESS, INC
Active
Other names
SULZBACHER VILLAGE PEDIATRIC HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY FUNKHOUSER (CEO)
(904) 394-4958
Entity
Organization
Contact information
Practice address
5455 SPRINGFIELD BLVD, JACKSONVILLE, FL 32208-5166
(904) 394-4958
Mailing address
611 E ADAMS ST, JACKSONVILLE, FL 32202-2847
(904) 394-5481
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
06/08/2020
Last updated
06/08/2020
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