Carte Blanche Holdings, Inc

Primary specialty

Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X

License

ME42368 Issued in FL

Legal business name

CARTE BLANCHE HOLDINGS, INC

Doing business as

Medi Weightloss

Practice address

13546 Beach Blvd
Unit 2
Jacksonville, FL 32224-7232

Phone

(904) 574-5000

NPI assigned

Sep 15, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Blake A Kozol

Title

President

Phone

(904) 625-0038

Specialties & licenses 3

Addresses

Other names 1

• Medi Weightloss Doing business as

Locations

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1558730085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 N LIBERTY ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064649",
            "telephone_number": "904-625-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13546 BEACH BLVD",
            "address_2": "UNIT 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322247232",
            "telephone_number": "904-574-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARTE BLANCHE HOLDINGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A",
        "authorized_official_last_name": "KOZOL",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-625-0038",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "FL",
            "license": "ME42368",
            "primary": true
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medi Weightloss",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kasidy Dale Carson, DO
• Stephanie Jo Carstens, MD
• Franklin Carswell
• Kathyrn Diane Carswell
• Candice M Carta, LCSW
• Brittany Patricia Carter- Best, LCSW
• Lillie Carter-Ford
• Deedee Carter-Saks, LNP, DNP
• Amber Larae Carter
• Andrew Carter

• Obesity Medicine (Family Medicine) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Obesity Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.