Jacksonville Concierge Medicine LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

JACKSONVILLE CONCIERGE MEDICINE LLC

Practice address

7643 Gate Pkwy Ste 104-909
Jacksonville, FL 32256-3092

Phone

(904) 925-8540

NPI assigned

Jun 16, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Kyle Mikals, MDNPI 1730504879

Title

Owner

Phone

(904) 925-1951

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyle Mikals, M.D.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1730504879
  Medicare reassignment NPD Authorized official
• Samantha Jeannette Mikals, M.D.

  • Otolaryngology Physician
  • Jacksonville, FL
  • NPI 1265870653
  NPD (past)

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756166400000",
    "number": "1891681037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7643 GATE PKWY STE 104-909",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563092",
            "telephone_number": "904-925-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7643 GATE PKWY STE 104-909",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563092",
            "telephone_number": "904-925-8540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5011 Gate Parkway Bldg 100",
            "address_2": "SUite 100 PMB 1064",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322567229",
            "country_code": "US",
            "telephone_number": "904-925-1951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACKSONVILLE CONCIERGE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A",
        "authorized_official_last_name": "MIKALS",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-925-1951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.