Organization
ST VINCENTS AMBULATORY CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRANDA HEMM (ENROLLMENT MANAGER)
(904) 450-6004
Entity
Organization
Contact information
Practice address
2 SHIRCLIFF WAY, SUITE 600, JACKSONVILLE, FL 32204-4742
(904) 308-6769
(904) 308-4072
Mailing address
4500 SALISBURY RD STE 210, JACKSONVILLE, FL 32216-0968
(904) 308-7959
(904) 308-7938
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
FL
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
FL
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
FL
207T00000X
Neurological Surgery Physician
—
FL
207T00000X
Neurological Surgery Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
FL
208600000X
Surgery Physician
—
FL
2086S0129X
Vascular Surgery Physician
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276587000
—
FL
Enumeration date
07/05/2006
Last updated
10/17/2022
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