Organization
JACKSONVILLE HEALTHCARE GROUP INC
Active
Other names
National Telemedicine Providers
Organization subpart
No
Provider details
NPI number
Authorized official
DIORGI LOPEZ SURI APRN (PRESIDENT)
(866) 372-0308
Entity
Organization
Contact information
Practice address
6821 SOUTHPOINT DR N STE 107, JACKSONVILLE, FL 32216-8026
(866) 372-0308
(877) 460-4651
Mailing address
6821 SOUTHPOINT DR N STE 107, JACKSONVILLE, FL 32216-8026
(866) 372-0308
(877) 460-4651
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000195965
—
CO
Enumeration date
04/21/2021
Last updated
10/05/2021
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