Jacksonville Ms and Neurology Center, P.a.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME59449 Issued in FL

Legal business name

JACKSONVILLE MS AND NEUROLOGY CENTER, P.A.

Practice address

1895 Kingsley Ave Ste 903
Orange Park, FL 32073-4410

Phone

(904) 276-1663

Fax

(904) 276-2469

NPI assigned

Nov 5, 2009

Last updated

Jan 24, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Victor A Maquera, MDNPI 1891786059

Title

President

Phone

(904) 276-1663

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Victor A Maquera, MD

  • Neurology Physician
  • Orange Park, FL
  • NPI 1891786059
  Authorized official Same address or phone

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1922335389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17809",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322457809",
            "telephone_number": "904-723-5665",
            "fax_number": "904-338-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 KINGSLEY AVE STE 903",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734410",
            "telephone_number": "904-276-1663",
            "fax_number": "904-276-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE MS AND NEUROLOGY CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-05",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "MAQUERA",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-276-1663",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME59449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "28344",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.