Jax Visiting Medical Providers LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

JAX VISITING MEDICAL PROVIDERS LLC

Practice address

9957 Moorings Dr
204
Jacksonville, FL 32257-2412

Phone

(904) 513-4947

Fax

(904) 513-4948

NPI assigned

Feb 9, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Lilian P Obrero-Gines, MD

Title

Physician

Phone

(904) 513-4947

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454976000000",
    "number": "1679931372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SHEFFIELD PARK CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322252667",
            "telephone_number": "904-382-2608",
            "fax_number": "904-221-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9957 MOORINGS DR",
            "address_2": "204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572412",
            "telephone_number": "904-513-4947",
            "fax_number": "904-513-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAX VISITING MEDICAL PROVIDERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-02-09",
        "status": "A",
        "authorized_official_last_name": "OBRERO-GINES",
        "authorized_official_first_name": "LILIAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "904-513-4947",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; 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.