Organization
JACKSONVILLE AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE THIBODEAUX (CHIEF ADMINISTRATIVE OFFICER)
(904) 889-0061
Entity
Organization
Contact information
Practice address
75 BARREN WAY, ST. JOHNS, FL 32259
(904) 889-0061
Mailing address
75 BARREN WAY, ST. JOHNS, FL 32259
(904) 889-0061
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/20/2026
Last updated
01/20/2026
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