Northeast Florida Primary Care Clinic
Legal Business Name
Northeast Florida Primary Care Clinic
NPI Number
1235232273
NPI Type
Organization
Enumeration Date
09/06/2006
Specialties
(Taxonomies)Code
207Q00000X
207R00000X
Primary Taxonomy
No
No
Licenses
State
Florida
Florida
License Number
ME0076341
ME0068123
Contact
Information
Purpose
Mailing
Location
Address
1835 EAST-WEST PARKWAY
1835 EAST-WEST PARKWAY
City
Orange Park
Orange Park
State
FL
FL
Postal Code
32003
32003
Country
US
US
Telephone Number
(904) 215-9266
(904) 215-9266
Authorized Official
Name
Dr. Jack Pulwers
Title or Position
PRESIDENT
Telephone Number
(904) 215-9266
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/22/2020