NPIMap

Organization Active NPI

Florida Physician Specialists LLC

  • Radiation Oncology Physician
  • Jacksonville, FL
National Provider Identifier
1033544390
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
FLORIDA PHYSICIAN SPECIALISTS LLC
Practice address
7017 A C Skinner Pkwy
Jacksonville, FL 32256-6932
Phone
(904) 520-6800
Fax
(904) 520-6801
NPI assigned
Sep 5, 2013
Last updated
Sep 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Meaghan Colleen Lutz
Title
Cfo
Phone
(904) 520-6800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X FL Primary

Addresses

Primary practice location

7017 A C Skinner Pkwy
Jacksonville, FL 32256-6932

Mailing address

7017 A C Skinner Pkwy
Jacksonville, FL 32256-6932
Phone (904) 520-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121130000298 FL Part B Supplier - Clinic/Group Practice 4486806213 Receives reassigned benefits from 53 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Orange Park, FL; Jacksonville Beach, FL

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2177753Florida Physician Specialists7017 A C Skinner Parkway, Jacksonville, FL 32256Certificate of waiverJan 16, 2028

National Provider Directory

National Provider Directory

Locations

3599 University Blvd S
Ste 907
Jacksonville, FL 32216

7017 A C Skinner Pkwy
Jacksonville, FL 32256
Phone (904) 520-6800

710 Lomax St
Ste L
Jacksonville, FL 32204

836 Prudential Dr
Ste 1502
Jacksonville, FL 32207
Phone (904) 396-5540

1577 Roberts Dr
Ste 220
Jacksonville Beach, FL 32250
Phone (904) 727-7955

6690 Crill Ave
Palatka, FL 32177
Phone (386) 325-4541

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 53

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1033544390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7017 A C SKINNER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566932",
            "telephone_number": "904-520-6800",
            "fax_number": "904-520-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7017 A C SKINNER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566932",
            "telephone_number": "904-520-6800",
            "fax_number": "904-520-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PHYSICIAN SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-05",
        "last_updated": "2021-09-16",
        "certification_date": "2021-08-13",
        "status": "A",
        "authorized_official_last_name": "LUTZ",
        "authorized_official_first_name": "MEAGHAN",
        "authorized_official_middle_name": "COLLEEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "904-520-6800"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.