Jacksonville Impotence Treatment Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

ME0053960 Issued in FL

Legal business name

JACKSONVILLE IMPOTENCE TREATMENT CENTER

Practice address

2950 Halcyon Lane
Suite706
Jacksonville, FL 32223

Phone

(904) 880-1366

Fax

(904) 880-8038

NPI assigned

Jun 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Roger James Miller Jr., M.D.

Title

President., Jitc

Phone

(904) 880-1366

Specialties & licenses 1

Addresses

Other names 1

• JITC Doing business as

Locations

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1508893579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 HALCYON LANE",
            "address_2": "SUITE706",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-880-1366",
            "fax_number": "904-880-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 HALCYON LANE",
            "address_2": "SUITE706",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-880-1366",
            "fax_number": "904-880-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE IMPOTENCE TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT., JITC",
        "authorized_official_telephone_number": "904-880-1366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "ME0053960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JITC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacksonville Health Alliance, LLC
• Jacksonville Health Clinic PA
• Jacksonville Healthcare Group Inc
• Jacksonville Hospitalists PA
• Jacksonville Imaging Center, LLC
• Jacksonville Injury Treatment Center LLC
• Jacksonville Institute of Family Care, P.a.
• Jacksonville Integrative Health LLC
• Jacksonville Internal Medicine
• Jacksonville Kidney Center LLC

• Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.