National Provider Identifier Database

IMPACT 13 MEDICAL PLLC
Neurology

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.


Contact Information

IMPACT 13 MEDICAL, PLLC
10752 DEERWOOD PARK BLVD
SOUTH WATERVIEW II SUITE 100
JACKSONVILLE, FL32256
Phone: 904-755-1017
Fax: 646-774-0386
Website:
Specialty Taxonomy Code
* Neurology 2084N0400X
Child & Adolescent Psychiatry 2084P0804X
Clinical 1041C0700X
Geriatric Psychiatry 2084P0805X
Psychiatric/Mental Health 363LP0808X

* Indicates primary specialty

NPI Profile & details for IMPACT 13 MEDICAL, PLLC

NPI Number 1548805617
Legal business name
LBN
IMPACT 13 MEDICAL, PLLC
Authorized official WIL GERMAIN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 11/13/2019
Last updated 12/18/2019 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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