Organization
LIFE EXTENSION CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY CAPASSO MD (MEDICAL DIRECTOR)
(904) 296-1790
Entity
Organization
Contact information
Practice address
4130 SALISBURY RD STE 2400, JACKSONVILLE, FL 32216-8052
(904) 296-1790
Mailing address
4130 SALISBURY RD STE 2400, JACKSONVILLE, FL 32216-8052
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
ARNP9414152
FL
Other
Enumeration date
02/24/2016
Last updated
02/24/2016
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