Organization
PHYSICIAN ASSOCIATES OF JACKSONVILLE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAG RAVICHANDRAN M.D. (ADMINISTRATOR)
(904) 389-3770
Entity
Organization
Contact information
Practice address
2700 RIVERSIDE AVENUE, SUITE#14, JACKSONVILLE, FL 32205
(904) 389-3770
(904) 389-3703
Mailing address
PO BOX 54246, JACKSONVILLE, FL 32245
(904) 389-3770
(904) 389-3703
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME741014
FL
Other
Enumeration date
01/03/2007
Last updated
02/06/2012
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