FLEMING ISLAND PLASTIC SURGERY LLC – NPI #1245602069
Surgery

A surgeon who specializes in plastic and reconstructive surgery.

Health Care Provider Taxonomy Code for Surgery

FLEMING ISLAND PLASTIC SURGERY LLC is a surgeon located in FLEMING ISLAND, FL. NPPES has assigned the NPI number 1245602069 to FLEMING ISLAND PLASTIC SURGERY LLC on October 21, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2086S0122X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Plastic and Reconstructive Surgery

The NPI profile was last updated on Sep 13, 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 FLEMING ISLAND PLASTIC SURGERY LLC below.

NPI Profile for
FLEMING ISLAND PLASTIC SURGERY LLC

NPI Number
1245602069
Enumeration Date

(more than 10 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
FLEMING ISLAND PLASTIC SURGERY LLC
Primary location
1715 EAGLE HARBOR PKWY STE B
FLEMING ISLAND, FL 32003-4324
Phone: (904) 990-3477 Fax: (904) 621-9272
Mailing address
916 ALAMEDA LN
SAINT JOHNS, FL 32259-6903
Phone: (904) 348-0727 Fax: (904) 621-9272
Organization Subpart
No
Authorized Official
WILLIAM WALLACE
MANAGER/OWNER
Phone: (904) 990-3477
Updated
Certification Date
Sep 13, 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.

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
2086S0122X
- Surgery / Plastic and Reconstructive Surgery (Primary)		 FL ME107749

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.