JACKSONVILLE CHILDREN'S SURGERY CENTER, LLC – NPI #1770620742
Clinic/Center

JACKSONVILLE CHILDREN'S SURGERY CENTER, LLC is an AHC clinic located in JACKSONVILLE, FL. NPPES has assigned the NPI number 1770620742 to JACKSONVILLE CHILDREN'S SURGERY CENTER, LLC on January 31, 2007. 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 Jan 27, 2025. 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 CHILDREN'S SURGERY CENTER, LLC below.

NPI Profile for
JACKSONVILLE CHILDREN'S SURGERY CENTER, LLC

NPI Number
1770620742
Enumeration Date

(more than 19 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 CHILDREN'S SURGERY CENTER, LLC
Primary location
3599 UNIVERSITY BLVD S STE 604
JACKSONVILLE, FL 32216-4234
Phone: (904) 525-8629 Fax:
Mailing address
9709 LAKESIDE BLVD STE 350
SPRING, TX 77381-1213
Phone: (713) 489-2198 Fax: (713) 489-2978
Organization Subpart
No
Authorized Official
DEVIN LARSEN
CEO
Phone: (208) 340-1840
Updated
Certification Date
Jan 27, 2025

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 CHILDREN'S SURGERY CENTER, LLC

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
otherBLUE CROSS BLUE SHIELDFL683
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 390

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.