NPIMap

Organization Active NPI

Arthritic Diseases Clinic

  • Medical Specialty Clinic/Center
  • Ponte Vedra Beach, FL
National Provider Identifier
1124411525
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
51858 Issued in FL
Legal business name
ARTHRITIC DISEASES CLINIC
Practice address
130 Professional Dr
Ponte Vedra Beach, FL 32082-1202
Phone
(904) 285-1113
Fax
(904) 285-3110
NPI assigned
Mar 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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

Authorized official

Name
Dr. Cecilia C. Olazar, M.D.NPI 1184621229
Title
Director
Phone
(904) 285-1113

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 51858 FL Primary

Addresses

Primary practice location

130 Professional Dr
Ponte Vedra Beach, FL 32082-1202

Mailing address

130 Professional Dr
Ponte Vedra Beach, FL 32082-1202
Phone (904) 285-1113

National Provider Directory

National Provider Directory

Locations

130 Professional Dr
Ponte Vedra Beach, FL 32082
Phone (904) 285-1113

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425859200000",
    "number": "1124411525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 PROFESSIONAL DR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320821202",
            "telephone_number": "904-285-1113",
            "fax_number": "904-285-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PROFESSIONAL DR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320821202",
            "telephone_number": "904-285-1113",
            "fax_number": "904-285-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARTHRITIC DISEASES CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-09",
        "last_updated": "2015-03-09",
        "status": "A",
        "authorized_official_last_name": "OLAZAR",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-285-1113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "51858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.