Southside Family Practice &Womens Health PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME83942 Issued in FL

Legal business name

SOUTHSIDE FAMILY PRACTICE &WOMENS HEALTH PA

Practice address

8075 Gate Pkwy W
Suite 102&103
Jacksonville, FL 32216-3684

Phone

(904) 296-1010

Fax

(904) 296-0393

NPI assigned

Mar 13, 2007

Last updated

Dec 4, 2012By 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

Dr. Suparna Gulani, M.DNPI 1114989415

Title

Medical Director

Phone

(904) 296-1010

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Suparna A Gulani, M.D

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1114989415
  Medicare reassignment NPD Authorized official
• Arun C Gulani, M.D

  • Specialist
  • Jacksonville, FL
  • NPI 1902890007
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1326171190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8075 GATE PKWY W",
            "address_2": "SUITE 102&103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163684",
            "telephone_number": "904-296-1010",
            "fax_number": "904-296-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8075 GATE PKWY W",
            "address_2": "SUITE 102&103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163684",
            "telephone_number": "904-296-1010",
            "fax_number": "904-296-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE FAMILY PRACTICE &WOMENS HEALTH PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "GULANI",
        "authorized_official_first_name": "SUPARNA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "904-296-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME83942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southside Aspen PLLC
• Southside Counseling Biofeedback & Stress Management Center, Inc
• Southside Counseling Biofeedback and Stress Management Center
• Southside Counselling Center LLC
• Southside Dermatology, P.a.
• Southwest Jacksonville Dialysis Center LLC (Normandy Village Dialysis Center)
• Southwood Nursing Center
• Lauryn Souvenir
• Alyssa Souza
• Lexxy Souza

• Specialist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.