Organization
NORTHEAST FLORIDA ENDOCRINE AND DIABETES ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELENA F ORAVETZ (CREDENTIALING)
(904) 384-2240
Entity
Organization
Contact information
Practice address
1375 ROBERTS DR STE 206, JACKSONVILLE, FL 32250-3209
(904) 384-2240
(904) 384-6055
Mailing address
1375 ROBERTS DR, SUITE 202, JACKSONVILLE, FL 32250-3210
(904) 384-2240
(904) 384-6055
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374606200
—
FL
Enumeration date
05/30/2007
Last updated
06/21/2024
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