North Florida Center for Preventive Medicine PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTH FLORIDA CENTER FOR PREVENTIVE MEDICINE PA

Practice address

14546 Old Saint Augustine Rd
Suite 211
Jacksonville, FL 32258-5468

Phone

(904) 268-5590

Fax

(904) 268-8305

NPI assigned

Sep 19, 2005

Last updated

Jan 17, 2013By 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. John Kalam, MD

Title

President/Ceo

Phone

(904) 268-5590

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1508851270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14546 OLD SAINT AUGUSTINE RD",
            "address_2": "SUITE 211",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585468",
            "telephone_number": "904-268-5590",
            "fax_number": "904-268-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14546 OLD SAINT AUGUSTINE RD",
            "address_2": "SUITE 211",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585468",
            "telephone_number": "904-268-5590",
            "fax_number": "904-268-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FLORIDA CENTER FOR PREVENTIVE MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "KALAM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "904-268-5590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Jan 17, 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.