Organization
USCG CLINIC JACKSONVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA FITZGERALD (HEALTH SYSTEM ANALYST)
(757) 628-4363
Entity
Organization
Contact information
Practice address
300 E MAIN ST, NORFOLK, VA 23510-1753
(757) 628-4363
Mailing address
10426 ALTA DR, JACKSONVILLE, FL 32226-2302
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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