NPIMap

Organization Active NPI

St Nicholas Ambulatory Surgical Center PA

  • Ambulatory Surgical Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1194154161
Registry record updated Nov 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ST NICHOLAS AMBULATORY SURGICAL CENTER PA
Practice address
2570 Atlantic Blvd
Jacksonville, FL 32207-3604
Phone
(904) 647-8576
Fax
(904) 253-3098
NPI assigned
Nov 11, 2013
Last updated
Nov 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2013

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

Authorized official

Name
Dr. Rene U Pulido, MDNPI 1033357553
Title
President
Phone
(904) 647-8576

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

2570 Atlantic Blvd
Jacksonville, FL 32207-3604

Mailing address

2624 Atlantic Blvd
Jacksonville, FL 32207-3668
Phone (904) 647-8576

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384128000000",
    "number": "1194154161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073668",
            "telephone_number": "904-647-8576",
            "fax_number": "904-253-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073604",
            "telephone_number": "904-647-8576",
            "fax_number": "904-253-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST NICHOLAS AMBULATORY SURGICAL CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-11",
        "last_updated": "2013-11-11",
        "status": "A",
        "authorized_official_last_name": "PULIDO",
        "authorized_official_first_name": "RENE",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-647-8576",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "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 Nov 11, 2013; 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.