Organization
NORTHEAST FLORIDA ENDOCRINE AND DIABETES ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENA CLAY (OFFICE MGR)
(904) 384-2240
Entity
Organization
Contact information
Practice address
1635 EAGLE HARBOR PARKWAY, SUITE 5, FLEMING ISLANG, FL 32003-4827
(904) 384-2240
(904) 384-6055
Mailing address
1635 EAGLE HARBOR PARKWAY, SUITE 5, FLEMING ISLANG, FL 32003-4827
(904) 384-2240
(904) 384-6055
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
332BC3200X
Customized Equipment (DME)
Primary
5497720001
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374606200
—
FL
Enumeration date
05/30/2007
Last updated
10/18/2012
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