NPIMap

Organization Active NPI

University of Florida Jacksonville Physicians Inc

Doing business as UF Health Molecular Pathology Laboratory

  • Clinical Medical Laboratory
  • Jacksonville, FL
National Provider Identifier
1407016645
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS INC
Doing business as
UF Health Molecular Pathology Laboratory
Practice address
655 W 11TH St
Jacksonville, FL 32206-3516
Phone
(904) 633-0989
Fax
(904) 244-4060
NPI assigned
Jun 11, 2008
Last updated
Aug 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Authorized official

Name
Guy I BenrubiNPI 1316912603
Title
Ceo/Vice President
Phone
(904) 244-3109

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
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

655 W 11TH St
Jacksonville, FL 32206-3516

Mailing address

PO Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008
Phone (904) 244-3660

Other names 1

  • UF Health Molecular Pathology Laboratory Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080731000624 FL Part B Supplier - Independent Clinical Laboratory 9133025869 Practice locations: Jacksonville, FL

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

655 W 11th St
Jacksonville, FL 32206
Phone (904) 633-0989

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
University of Florida Jacksonville Physicians, Inc.Saint Marys, GA, CCN 118918 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 3, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1407016645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 11TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322063516",
            "telephone_number": "904-633-0989",
            "fax_number": "904-244-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "BENRUBI",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO/VICE PRESIDENT",
        "authorized_official_telephone_number": "904-244-3109"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UF Health Molecular Pathology Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.