Organization
JACKSONVILLE ORTHOPAEDIC INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RICCHINI (EXECUTIVE DIRECTOR)
(904) 346-3465
Entity
Organization
Contact information
Practice address
1348 S 18TH ST, SUITE 320B, FERNANDINA BEACH, FL 32034-4785
(904) 261-8787
(904) 261-9653
Mailing address
PO BOX 117345, ATLANTA, GA 30368-7345
(904) 346-3465
(904) 858-6489
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003151000
—
FL
01
—
CC4257
RR MEDICARE
FL
Enumeration date
11/22/2016
Last updated
01/24/2019
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