Organization
MOUNT GILEAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS CAREY MERRITT MD (PRESIDENT)
(904) 296-3113
Entity
Organization
Contact information
Practice address
6817 SOUTHPOINT PKWY, SUITE 304, JACKSONVILLE, FL 32216-6282
(904) 296-3113
(904) 296-3144
Mailing address
6817 SOUTHPOINT PKWY, SUITE 304, JACKSONVILLE, FL 32216-6282
(904) 296-3113
(904) 296-3144
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
603914
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
603914
STATE OF FLORIDA
FL
Enumeration date
06/09/2011
Last updated
06/09/2011
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