Sulzbacher Health Center

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

ARNP1071492 Issued in FL

Legal business name

SULZBACHER HEALTH CENTER

Practice address

611 E Adams St
Jacksonville, FL 32202-2847

Phone

(904) 394-8069

Fax

(904) 353-7345

NPI assigned

Dec 27, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mary Kelloge Robinson, M.D.

Title

Medical Director

Phone

(904) 394-8069

Specialties & licenses 1

Addresses

Tax ID family

Im Sulzbacher Center for the Homeless Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Im Sulzbacher Center for the Homeless Inc

  dba Beaches Community Healthcare

  • Federally Qualified Health Center (FQHC)
  • Jacksonville Beach, FL
  • NPI 1326312315
  NPD tax ID

Locations

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293408000000",
    "number": "1164726626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E ADAMS ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322022847",
            "telephone_number": "904-394-8069",
            "fax_number": "904-353-7345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E ADAMS ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322022847",
            "telephone_number": "904-394-8069",
            "fax_number": "904-353-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULZBACHER HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-27",
        "last_updated": "2010-12-27",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KELLOGE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "904-394-8069",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "FL",
            "license": "ARNP1071492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Kevin Sullivan
• Victor Sullivan Jr.
• Nicole Sultan
• Senan Sultan, M.D.
• Rachel Sultzer, CLC
• Rachel Sulzer
• Jessi N Suminski, BC-HIS
• Shanta D Sumlin
• Summer Brook FL SNF Management LLC (Healthcare Center of Jacksonville)
• Summerlin Imaging Center LLC

• Federally Qualified Health Center (FQHC) in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Federally Qualified Health Center (FQHC) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; 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.