Jeff Jacqmein MD,PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME71303 Issued in FL

Legal business name

JEFF JACQMEIN MD,PA

Practice address

3872 San Jose Park Dr
Jacksonville, FL 32217-4613

Phone

(904) 731-0304

Fax

(904) 732-2251

NPI assigned

Nov 4, 2010

Last updated

Nov 8, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Judy Anne Nickels

Title

Office Manager

Phone

(904) 731-0304

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1306147590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3872 SAN JOSE PARK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174613",
            "telephone_number": "904-731-0304",
            "fax_number": "904-732-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3872 SAN JOSE PARK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174613",
            "telephone_number": "904-731-0304",
            "fax_number": "904-732-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF JACQMEIN MD,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "NICKELS",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-731-0304"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME71303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naderge Jean, ARNP, MSN, FNP-BC
• Swetha Sundaralingam Jean, PA-C
• Jeanne D Montross Arnp PA
• Abdullah Jebrini, MD
• David Robert Jedrziewski, LMHC, LMFT
• Jefferson Caregiving Services
• Janet Jefferson Hastings
• Jefferson Health Care (Felicia Jefferson)
• Jefferson Pharmacy LLC
• Andrevius T Jefferson, PA

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.