PACIFICA CARE PLLC NPI 1669775037

NPI Information

NPI: 1669775037
Provider Name: PACIFICA CARE PLLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

CLIA Number: 10D2017795

Address:
13121 ATLANTIC BLVD
SUITE 100
JACKSONVILLE, FL
ZIP 32225
Phone: (904) 221-2232
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PACIFICA CARE PLLC is an adult mental health clinic center in Jacksonville, FL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. PACIFICA CARE PLLC NPI is 1669775037. The provider is registered as an organization entity type.

The provider's business location address is:

13121 ATLANTIC BLVD
SUITE 100
JACKSONVILLE, FL
ZIP 32225
Phone: (904) 221-2232
Fax: (904) 221-2205

The provider's authorized official is Peggy A Arcanz .
The authorized official title is Administrator and has the following contact phone number (904) 221-2232.

The CLIA number assigned to this NPI record is 10D2017795 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/7/2010 and was last updated on 1/10/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health	9102783	FLORIDA	No
2	261QM0850X	Clinic/Center	Adult Mental Health	HCC8789	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	U6812A	MEDICARE PIN	FLORIDA
2	292650400	MEDICAID	FLORIDA
3	Q02170	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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