NPI 1710654199 · live from the CMS NPI Registry
Ace Medical Group LLC
Internal Medicine in Jacksonville, FL. National Provider Identifier 1710654199, active.
NPI record
| NPI | 1710654199 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine 207R00000X |
| Practice location | 6428 Beach Blvd, Jacksonville, FL 32216 |
| Practice phone | 904-475-2039 |
| Enumerated | August 24, 2021 |
| Last updated | August 24, 2021 |
| Authorized official | Joseph Ellyson, Chief Operations Officer |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine | 207Q00000X | — |
| Clinic/Center, Multi-Specialty | 261QM1300X | — |
| Physician Assistant | 363A00000X | — |
| Nurse Practitioner, Adult Health | 363LA2200X | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — |
| Internal Medicine primary | 207R00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.