Provider Demographics
NPI:1194409615
Name:UF HEALTH ACO JACKSONVILLE, LLC
Entity type:Organization
Organization Name:UF HEALTH ACO JACKSONVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:WENDEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:LANDKROHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-244-3603
Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:904-244-9533
Mailing Address - Fax:904-244-9501
Practice Address - Street 1:653 W 8TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-9533
Practice Address - Fax:904-244-9501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty