CENTURION SURGERY CENTER OF JACKSONVILLE, LLC – NPI #1053059220
Clinic/Center

CENTURION SURGERY CENTER OF JACKSONVILLE, LLC is an AHC clinic located in JACKSONVILLE, FL. NPPES has assigned the NPI number 1053059220 to CENTURION SURGERY CENTER OF JACKSONVILLE, LLC on May 26, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was last updated on Feb 25, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CENTURION SURGERY CENTER OF JACKSONVILLE, LLC below.

NPI Profile for
CENTURION SURGERY CENTER OF JACKSONVILLE, LLC

NPI Number
1053059220
Enumeration Date

(more than 4 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CENTURION SURGERY CENTER OF JACKSONVILLE, LLC
Primary location
5191 FIRST COAST TECH PKWY
1ST FLOOR
JACKSONVILLE, FL 32224
Phone: (904) 593-5146 Fax: (904) 593-6642
Mailing address
5191 FIRST COAST TECH PKWY FL 1
JACKSONVILLE, FL 32224-0609
Phone: (904) 593-5146 Fax: (904) 593-6642
Organization Subpart
No
Authorized Official
ALICIA GROTH
CREDENTIALING MANAGER
Phone: (904) 223-3321
Updated
Certification Date
Feb 25, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.