JACKSONVILLE INTERNAL MEDICINE (NPI# 1013093152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013093152 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE INTERNAL MEDICINE |
| Practice Address |
1465 1st Ave Sw Ste B Jacksonville AL 36265-3323 |
| Mailing Address |
Po Box 550 Jacksonville AL 36265-0550 |
| Practice Telephone | 6784324755 |
| Practice Fax Number | 6784324753 |
| Mailing Telephone | 6784324755 |
| Mailing Fax Number | 6784324753 |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. REY GAVINO (OWNER) |
| Authorized Official Telephone | 6784324755 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 25404 | AL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962607739 | Jacksonville Internal Medicine | Internal Medicine | 6144 Gazebo Park Pl S, Suite 102, Jacksonville, FL 32257-1099 | 2007-06-20 |
| 1811066103 | Jacksonville Internal Medicine | Internal Medicine | 2270 Pelham Rd S, Jacksonville, AL 36265-9582 | 2006-11-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Alabama Business Registrations | Jacksonville Internal Medicine & Wellness, LLC | 1701 Pelham Road South Suite B, Jacksonville, AL 36265 |
| Street Address |
1465 1ST AVE SW STE B |
| City | JACKSONVILLE |
| State | AL |
| Zip Code | 36265-3323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700436144 | Griffin Loflin | Specialist/Technologist | 775 Park Ave Nw, Attn. Sports Medicine, Jacksonville, AL 36265 | 2019-09-17 |
| 1114304011 | Caroline Ross | Counselor | 1215 Jackson Way Sw, Jacksonville, AL 36265 | 2015-04-29 |
| 1083001226 | Tracey Hudgins | Counselor | 1215 Jackson's Way, Jacksonville, AL 36265 | 2015-04-24 |
| 1235415118 | Adam Pike | Pharmacist | 311 Pelham Rd So, Jacksonville, AL 36265 | 2011-10-24 |
| 1386829489 | Physicians Choice Dialysis of Jacksonville, LLC | Clinic/Center | 331 Henry Road Sw, Jacksonville, AL 36265 | 2008-01-08 |
| 1659409365 | Kenneth Wayne Campbell | Nurse Anesthetist, Certified Registered | 1701 Pelham Road, Jacksonville Medical Center, Jacksonville, AL 36265 | 2007-03-02 |
| 1154478378 | Diana C. Ford | Counselor | 1250 Jackson's Way, Garrett Counseling Center, Jacksonville, AL 36265 | 2007-01-03 |
| 1487710950 | James Richard Morrison | Chiropractor | 1550 Pelham Rd. S., Jacksonville, AL 36265 | 2006-12-29 |
| 1447332937 | Millennium Anesthesia Services | Anesthesiology | 1701 Pelham Road S, Jacksonville, AL 36265 | 2006-10-20 |
| 1407943228 | Brunda Revanna, Md | Clinic/Center | 1465 A 1st Ave Sw Ste C, Jacksonville, AL 36265 | 2006-10-05 |
| Find all providers in zip 36265 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760004329 | Colin Craig Rowell | Internal Medicine | 4500 San Pablo Rd S Fl 32, Jacksonville, FL 32224-1865 | 2020-05-17 |
| 1457982977 | Ateeque Khan, Md P.a. | Internal Medicine | 3659 Eastbury Dr, Jacksonville, FL 32224-1659 | 2020-02-03 |
| 1013478221 | Naji Maaliki | Internal Medicine | 653-1 W 8th St Fl L184, Jacksonville, FL 32209-6511 | 2019-03-29 |
| 1770043259 | Fadi Kandah | Internal Medicine | 653-1 W 8th St # L15, Jacksonville, FL 32209-6511 | 2019-03-21 |
| 1346696002 | Alana Akers | Internal Medicine | 203 Nacogdoches St Ste 290, Jacksonville, TX 75766-2444 | 2016-05-11 |
| 1346602927 | Kevin Roy Green | Internal Medicine | 653-1 W 8th St # L18, Jacksonville, FL 32209-6511 | 2016-03-23 |
| 1093175770 | Alex Balmir | Internal Medicine | 655 W 8th St # Cc262, Jacksonville, FL 32209-6511 | 2016-02-24 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1316338957 | Deep Patel | Internal Medicine | 5238 Norwood Ave Ste 16, Jacksonville, FL 32208-5005 | 2015-02-17 |
| 1063801934 | Avecina Medical | Internal Medicine | 9580 Applecross Rd, 106, Jacksonville, FL 32222-5845 | 2015-01-15 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 36265 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.