Individual
JAMIE T SURRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3599 UNIVERSITY BLVD S, BUILDING 300, JACKSONVILLE, FL 32216-4252
(904) 399-5550
(904) 346-4334
Mailing address
3599 UNIVERSITY BLVD S, BUILDING 300, JACKSONVILLE, FL 32216-4252
(904) 399-5550
(904) 346-4334
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
ME62463
FL
2085N0700X
Neuroradiology Physician
ME62463
FL
2085N0904X
Nuclear Radiology Physician
ME62463
FL
2085P0229X
Pediatric Radiology Physician
ME62463
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME62463
FL
2085R0204X
Vascular & Interventional Radiology Physician
ME62463
FL
2085U0001X
Diagnostic Ultrasound Physician
ME62463
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00529867B
—
GA
01
—
18063
BCBS
FL
05
—
370978700
—
FL
Enumeration date
03/24/2006
Last updated
03/17/2010
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