Mandarin Family Medicine, P.a.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

OS3739 Issued in FL

Legal business name

MANDARIN FAMILY MEDICINE, P.A.

Practice address

12276-210 San Jose Blvd
Jacksonville, FL 32223

Phone

(904) 268-9266

Fax

(904) 292-1482

NPI assigned

Dec 18, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Rodney A Marcom, D.O.

Title

Doctor

Phone

(904) 268-9266

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1891031910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12276-210 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-268-9266",
            "fax_number": "904-292-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12276-210 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-268-9266",
            "fax_number": "904-292-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANDARIN FAMILY MEDICINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-18",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "MARCOM",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "904-268-9266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "FL",
            "license": "OS3739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Preferred Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.