CLEANSLATE MEDICAL GROUP OF FLORIDA, PLLC
NPI 1225577760
Internal Medicine - Addiction Medicine in Jacksonville, FL

Q: What is Cleanslate Medical Group Of Florida, PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

Active since February 16, 2017

1128 N LAURA ST, JACKSONVILLE, FL 32206(904) 425-0400 Get Directions Write a Review

NPPES record last updated: July 2, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 2, 2019, Feb 16, 2017 (2 updates tracked since 2017).

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About Cleanslate Medical Group Of Florida, Pllc NPPES

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

CLEANSLATE MEDICAL GROUP OF FLORIDA, PLLC (NPI 1225577760) is a healthcare organization registered as an addiction medicine in Jacksonville, Florida and active in the NPI registry since February 2017. The organization lists Robert Hutchison, Cfo, as its authorized official.

NPPES Registry Identity

NPI1225577760

Entity TypeOrganization

Primary Taxonomy207RA0401X

Legal Business NameCLEANSLATE MEDICAL GROUP OF FLORIDA, PLLC

Location Address1128 N LAURA STJacksonville, FL 32206-4912

Mailing Address15 Century Blvd Ste 307Nashville, TN 37214-3692 · (615) 425-0220

Phone(904) 425-0400

Organization SubpartNo

Authorized OfficialRobert HutchisonCfo · (413) 584-2173

Enumeration DateFebruary 16, 2017

Last NPPES UpdateJuly 2, 20192 updates tracked since enumeration

✔ NPI 1225577760 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Addiction MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RA0401X

Definition

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.

1128 N LAURA ST, Jacksonville, FL 32206

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 15

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

AMY L WILEY M.S., CCC-SLP

Speech-Language Pathologist