JACKSONVILLE BEACH SURGERY CENTER – NPI #1497723720
Clinic/Center

JACKSONVILLE BEACH SURGERY CENTER is an AHC clinic located in JACKSONVILLE BEACH, FL. NPPES has assigned the NPI number 1497723720 to JACKSONVILLE BEACH SURGERY CENTER on March 11, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “JACKSONVILLE BEACH SURGERY CENTER” is a dba name, the actual legal business name for this organization is JACKSONVILLE BEACH SURGERY CENTER, LLC. 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 Nov 18, 2024. 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 JACKSONVILLE BEACH SURGERY CENTER below.

NPI Profile for
JACKSONVILLE BEACH SURGERY CENTER, LLC

NPI Number
1497723720
Enumeration Date

(more than 20 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
JACKSONVILLE BEACH SURGERY CENTER, LLC
Doing Business As (dba): JACKSONVILLE BEACH SURGERY CENTER
Primary location
3316 SOUTH THIRD STREET
STE 200
JACKSONVILLE BEACH, FL 32250
Phone: (904) 247-8181 Fax: (904) 247-8101
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JENNIFER BALDOCK
OFFICER AND AUTHORIZED OFFICIAL
Phone: (615) 234-5954
Updated
Certification Date
Nov 18, 2024

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.

Identifiers

Identifiers for JACKSONVILLE BEACH SURGERY CENTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidFL070933600
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)
FL 1120

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.