BRANCH MEDICAL CLINIC JACKSONVILLE
NPI 1104331065
Clinic/Center - Military/U.S. Coast Guard Outpatient in Jacksonville, FL

Active since December 13, 2017
964 AJAX ST, JACKSONVILLE, FL 32214(904) 546-7094 Get Directions Write a Review

NPPES record last updated: December 13, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Branch Medical Clinic Jacksonville NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRANCH MEDICAL CLINIC JACKSONVILLE (NPI 1104331065) is a healthcare organization registered as a military/u.s. coast guard outpatient in Jacksonville, Florida and active in the NPI registry since December 2017. The organization lists William M Condon, Bumed Ubo, as its authorized official.

NPPES Registry Identity

NPI1104331065
Entity TypeOrganization
Primary Taxonomy261QM1100X
Legal Business NameBRANCH MEDICAL CLINIC JACKSONVILLE
Location Address964 AJAX STJacksonville, FL 32214-0001
Mailing Address2080 Child StJacksonville, FL 32214-5005
Organization SubpartYesParent: Naval Hospital Jacksonville
Authorized OfficialWilliam M CondonBumed Ubo · (240) 401-3643
Enumeration DateDecember 13, 2017
NPI 1104331065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Military/U.S. Coast Guard OutpatientAmbulatory Health Care Facilities
Taxonomy Code261QM1100X
Definition
The Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.
964 AJAX ST, Jacksonville, FL 32214

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist
964 AJAX ST
JACKSONVILLE, FL 32214
Dental Hygienist
964 AJAX ST
JACKSONVILLE, FL 32214

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Branch Medical Clinic Jacksonville's NPI number?

The NPI number for Branch Medical Clinic Jacksonville is 1104331065. It was assigned to this organization in the NPPES registry on December 13, 2017.

Where is Branch Medical Clinic Jacksonville located?

Branch Medical Clinic Jacksonville is located at 964 Ajax St, Jacksonville, FL 32214. The listed phone number is (904) 546-7094.

What is Branch Medical Clinic Jacksonville's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Military/U.S. Coast Guard Outpatient, with taxonomy code 261QM1100X.

When was this NPI record last updated?

The NPPES record for Branch Medical Clinic Jacksonville was last updated on December 13, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.