MEMORIAL URGENT CARE MANDARIN LLC NPI 1033193743

NPI Information

  • NPI: 1033193743
  • Provider Name: MEMORIAL URGENT CARE MANDARIN LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 10D2120198
  • Address: 11701 SAN JOSE BLVD
    SUITE 110
    JACKSONVILLE, FL
    ZIP 32223
  • Phone: (904) 306-8060

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NPI Details

MEMORIAL URGENT CARE MANDARIN LLC is a family medicine in Jacksonville, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MEMORIAL URGENT CARE MANDARIN LLC NPI is 1033193743. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

11701 SAN JOSE BLVD
SUITE 110
JACKSONVILLE, FL
ZIP 32223-756
Phone: (904) 306-8060
Fax: (904) 306-8065

The provider's authorized official is Mickey Pickler .
The authorized official title is Vp and has the following contact phone number (850) 523-2117.

The CLIA number assigned to this NPI record is 10D2120198 - other - free standing er with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 12/6/2005 and was last updated on 12/10/2007.

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
1207Q00000XFamily MedicineYes

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 Other Provider Identifier Issuer
1K8653MEDICARE PIN
2DE3436MEDICARE PIN

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: 11/21/2025

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