NPIMap

Organization Active NPI

Premise Health of Florida Medical, P.a.

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1780033498
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMISE HEALTH OF FLORIDA MEDICAL, P.A.
Practice address
5022 Gate Pkwy Ste 400
Jacksonville, FL 32256-0833
Phone
(904) 645-4060
Fax
(904) 645-4061
NPI assigned
Jun 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Jon Leizman, M.D.
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

5022 Gate Pkwy Ste 400
Jacksonville, FL 32256-0833

Mailing address

5500 Maryland Way
Attn RCM Dept
Brentwood, TN 37027-4948
Phone (904) 645-4060

Other names 1

  • Deutsche Bank Health Unit Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Florida Medical PA58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5022 Gate Pkwy
Ste 400
Jacksonville, FL 32256
Phone (904) 645-4060

NPI Registry JSON

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1780033498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "address_2": "ATTN RCM DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948",
            "telephone_number": "904-645-4060",
            "fax_number": "904-645-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5022 GATE PKWY STE 400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560833",
            "telephone_number": "904-645-4060",
            "fax_number": "904-645-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF FLORIDA MEDICAL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-03",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deutsche Bank Health Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Deutsche Bank Health Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.