NPIMap

Organization Active NPI

Carla M Vincent MD PA

  • Anesthesiology Physician
  • Jacksonville, FL
National Provider Identifier
1134344633
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
CARLA M VINCENT MD PA
Practice address
3625 University Blvd S
Jacksonville, FL 32216-4207
Phone
(904) 387-0006
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Authorized official

Name
Carla Vincent, MDNPI 1063406742
Title
Owner
Phone
(904) 387-0006

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
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

3625 University Blvd S
Jacksonville, FL 32216-4207

Mailing address

PO Box 57100
Jacksonville, FL 32241-7100

National Provider Directory

National Provider Directory

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1134344633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322417100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164207",
            "telephone_number": "904-387-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLA M VINCENT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-387-0006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "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 25, 2007; 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.