Medex Clinic, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME100337 Issued in FL

Legal business name

MEDEX CLINIC, LLC

Doing business as

Medex Clinic

Practice address

865 Cassat Ave
Jacksonville, FL 32205-4856

Phone

(904) 388-3229

Fax

(904) 388-8611

NPI assigned

Aug 13, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Asim Nouman, M.D

Title

President-MGRM

Phone

(904) 388-3229

Specialties & licenses 1

Addresses

Other names 1

• Medex Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408924800000",
    "number": "1750537445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 CASSAT AVE STE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322059615",
            "telephone_number": "904-388-3229",
            "fax_number": "904-207-7321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 CASSAT AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322054856",
            "telephone_number": "904-388-3229",
            "fax_number": "904-388-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEX CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2014-08-25",
        "status": "A",
        "authorized_official_last_name": "NOUMAN",
        "authorized_official_first_name": "ASIM",
        "authorized_official_title_or_position": "PRESIDENT-MGRM",
        "authorized_official_telephone_number": "904-388-3229",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME100337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medex Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brenda Medders, MSW
• Jamey Medders, CAA
• Jennifer Meder, RDN
• Saily Medero, RDN
• Natasha Mederos Rocha
• Medfund LLC
• Medfund LLC
• Medical Care Products Inc
• Medical Diagnostic Center of Jacksonville
• Medical Diagnostic Center of Jacksonville

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.