Organization
FIRST COAST DIABETES INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCIO CORREA (CEO)
(904) 703-3041
Entity
Organization
Contact information
Practice address
1126 UNIVERSITY BLVD N, JACKSONVILLE, FL 32211-8850
(904) 384-9303
Mailing address
1166 AUTUMN POINT CT, JACKSONVILLE, FL 32218-9029
(904) 703-3041
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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