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ACE MEDICAL LLC

Behavioral Health & Social Service Providers Psychologist

Provider NPI: 1265772370

Organization Information:
Organization Name:  ACE MEDICAL LLC
Organization is not Subpart
Authorized Official:  DIANA M CORDERO  OWNER/PRESIDENT  904-238-3752

Practice Location:
3720 BEACH BLVD  JACKSONVILLE, FL 32207-3814 US
Tel: 904-475-2039  Fax: 904-330-0668

Business Mailing Address:
9471 BAYMEADOWS RD SUITE 405 JACKSONVILLE, FL 32256-7932 US
Tel: 904-475-2039  Fax: --

NPI Information:
NPI: 1265772370
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103T00000XBehavioral Health & Social Service Providers
Psychologist
N204C00000XPhysicians
Neuromusculoskeletal Medicine, Sports Medicine
N207Q00000XPhysicians
Family Medicine
N207R00000XPhysicians
Internal Medicine
N208VP0000XPhysicians
Pain Medicine
N213E00000XPodiatric Medicine & Surgery Service Providers
Podiatrist
N261QP1100XAmbulatory Health Care Facilities
Clinic/Center
Y261QM1300XAmbulatory Health Care Facilities
Clinic/Center

Other Provider Identifiers:

IssuerNumberStateType
NSC763571000401



American Medical Association 2012 taxonomy code information

Code: 261QM1300X

Type:

Classification:



Definition:



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