Organization
COGENT HEALTHCARE OF JACKSONVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA FALL (MANAGER)
(253) 682-6040
Entity
Organization
Contact information
Practice address
1515 HERBERT ST STE 210, PORT ORANGE, FL 32129-6105
(386) 788-8313
Mailing address
5410 MARYLAND WAY STE 300, BRENTWOOD, TN 37027-5339
(866) 282-7905
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/29/2021
Last updated
03/07/2025
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