Provider Demographics
NPI:1154971075
Name:TURNER HEALTHCARE PLLC
Entity type:Organization
Organization Name:TURNER HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IVORIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:619-578-3763
Mailing Address - Street 1:102 QUEENSLAND CIR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-6063
Mailing Address - Country:US
Mailing Address - Phone:619-578-3763
Mailing Address - Fax:
Practice Address - Street 1:3002 N MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-4228
Practice Address - Country:US
Practice Address - Phone:904-355-5855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care