Organization
ST VINCENTS PHYSICIAN ENTERPRISE INC
Active
Parent organization
ST VINCENTS PRIMARY CARE
Other names
St Vincents Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST VINCENTS PRIMARY CARE
Authorized official
GENE MIYAMOTO (SYSTEM COO)
(904) 308-1290
Entity
Organization
Contact information
Practice address
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4712
(904) 308-7372
(904) 308-6909
Mailing address
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4712
(904) 308-7372
(904) 308-6909
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/01/2010
Last updated
09/02/2010
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