Organization
FIRST COAST COMMUNITY DEVELOPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLIE GRIFFIN (CEO/PRESIDENT)
(904) 866-7483
Entity
Organization
Contact information
Practice address
525 N NEWNAN ST, JACKSONVILLE, FL 32202-3121
(904) 379-8383
(904) 358-5618
Mailing address
525 N NEWNAN ST, JACKSONVILLE, FL 32202-3121
(904) 379-8383
(904) 358-5618
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Enumeration date
01/05/2022
Last updated
06/09/2025
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