Organization
JACKSONVILLE PLASTIC SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN J OBI M.D. (PRESIDENT)
(904) 346-0060
Entity
Organization
Contact information
Practice address
3599 UNIVERSITY BLVD S, SUITE 1600, JACKSONVILLE, FL 32216-4252
(904) 346-0060
(904) 346-0065
Mailing address
3599 UNIVERSITY BLVD S, SUITE 1600, JACKSONVILLE, FL 32216-4252
(904) 346-0060
(904) 346-0065
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME027754
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55094
MEDICARE ID NUMBER
FL
Enumeration date
06/20/2010
Last updated
09/28/2010
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