Organization
NORTHEAST FLORIDA ENDOCRINE AND DIABETES ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EILEEN VAN FOSSEN (PRACTICE ADMINISTRATOR)
(904) 384-2240
Entity
Organization
Contact information
Practice address
580 W 8TH ST, SUITE 6005, JACKSONVILLE, FL 32209-6533
(904) 384-2240
(904) 244-9607
Mailing address
580 W 8TH ST, SUITE 6005, JACKSONVILLE, FL 32209-6533
(904) 384-2240
(904) 244-9607
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374606200
—
FL
Enumeration date
05/30/2007
Last updated
07/03/2008
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