First Coast Diabetes Institute, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

FIRST COAST DIABETES INSTITUTE, LLC

Practice address

1126 University Blvd N
Jacksonville, FL 32211-8850

Phone

(904) 384-9303

NPI assigned

Jan 31, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Marcio Correa

Title

Ceo

Phone

(904) 703-3041

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359590400000",
    "number": "1588903231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 AUTUMN POINT CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322189029",
            "telephone_number": "904-703-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 UNIVERSITY BLVD N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322118850",
            "telephone_number": "904-384-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST DIABETES INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-31",
        "last_updated": "2013-01-31",
        "status": "A",
        "authorized_official_last_name": "CORREA",
        "authorized_official_first_name": "MARCIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-703-3041",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Coast Community Wellness Services LLC
• First Coast Counseling and Life Coaching, Inc.
• First Coast Counseling and Recovery
• First Coast Dental Center, PLLC
• First Coast Dermatology P a
• First Coast Eye Associates, PA
• First Coast Eyewear Inc
• First Coast Family Medicine PA
• First Coast Foot & Ankle Clinic Inc
• First Coast FS, LLC

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

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