Novocardia Jacksonville ASC LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Ponte Vedra, FL
NPI 1356068142 · NPPES record last updated Oct 24, 2022
Key facts
- NPI
- 1356068142
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- NOVOCARDIA JACKSONVILLE ASC LLC
- Practice address
- 153 Fort Wades Road
Ponte Vedra, FL 32081 - Phone
- (904) 423-0010
- NPI assigned
- Oct 24, 2022
- Organization subpart
- No
Authorized official
- Name
- Dan Blumenthal, MD
- Title
- Owner
- Phone
- (617) 694-1113
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
153 Fort Wades Road
Ponte Vedra, FL 32081
Mailing address
PO Box 47170
Jacksonville, FL 32247-7170
Phone (904) 423-0010
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.