Organization
ST VINCENT'S FULL SERVICE URGENT CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA MENDOZA (CHIEF REVENUE CYCLE SPECIALISTS)
(904) 450-6045
Entity
Organization
Contact information
Practice address
5501 ROOSEVELT BLVD, JACKSONVILLE, FL 32244-2345
(904) 683-9662
(904) 683-9640
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007294301
—
FL
Enumeration date
07/20/2018
Last updated
07/20/2018
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