Organization
MEDFUND LLC
Active
Other names
Horizon Jacksonville South LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN J KERN (SENIOR VICE PRESIDENT)
(941) 925-3490
Entity
Organization
Contact information
Practice address
1566 KINGSLEY AVE, ORANGE PARK, FL 32073-4511
(904) 278-2128
(904) 278-2129
Mailing address
240 N WASHINGTON BLVD, SARASOTA, FL 34236-5945
(941) 925-3490
(941) 953-4452
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
HCC5207
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V2398
BCBS PROV #
FL
Enumeration date
05/23/2005
Last updated
08/17/2018
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