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JACKSONVILLE ENT SURGERY CENTER
NPI 1457600769
Otolaryngology in Jacksonville, FL

Active since August 31, 2012
11512 LAKE MEAD AVE, STE 531, JACKSONVILLE, FL 32256(904) 419-2054(904) 419-2057 Get Directions Write a Review

NPPES record last updated: August 3, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jacksonville Ent Surgery Center NPPES

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

JACKSONVILLE ENT SURGERY CENTER (NPI 1457600769) is a healthcare organization registered as an otolaryngology in Jacksonville, Florida and active in the NPI registry since August 2012. The organization lists Charles C Greene, Owner, as its authorized official.

NPPES Registry Identity

NPI1457600769
Entity TypeOrganization
Primary Taxonomy207Y00000X
Legal Business NameCHARLES C GREENE MD PHD PA
Location Address11512 LAKE MEAD AVE, STE 531Jacksonville, FL 32256-9733
Mailing Address11512 Lake Mead Ave Unit 531Jacksonville, FL 32256-9733 · (904) 419-2054 · Fax (904) 419-2057
Phone(904) 419-2054
Fax(904) 419-2057
Organization SubpartNo
Authorized OfficialCharles C GreeneOwner · (904) 419-2054
Enumeration DateAugust 31, 2012
Last NPPES UpdateAugust 3, 2022
NPPES CertifiedAugust 3, 2022
✔ NPI 1457600769 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

11512 LAKE MEAD AVE, Jacksonville, FL 32256
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Other Names 1

Doing Business AsJacksonville Ent Surgery Center

Other Identifiers 2

Medicaid008103800FL
Other003PFFL · Fl Blue

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Other Providers at the Same Location NPPES 20

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

MRS. ELIZABETH JANE O'GRADY MS CCC-SLP
Speech-Language Pathologist
11512 LAKE MEAD AVE, SUITE 203
JACKSONVILLE, FL 32256
Duval County (904) 652-5408
CARYN BETH KENNY LCSW
Social Worker (Clinical)
11512 LAKE MEAD AVE, 703
JACKSONVILLE, FL 32256
Duval County (904) 646-0051
JAMES E HARDY MD PLASTIC SURGERY LLC
Plastic Surgery
11512 LAKE MEAD AVE, SUITE 605
JACKSONVILLE, FL 32256
Duval County (904) 996-0600
MELISSA AMERSON S.L.P.
Speech-Language Pathologist
11512 LAKE MEAD AVE, SUITE 203
JACKSONVILLE, FL 32256
Duval County (904) 652-5408
LITTLE STAR CENTER, INC
Behavior Analyst
11512 LAKE MEAD AVE, SUITE 511
JACKSONVILLE, FL 32256
Duval County (904) 928-0112
LIVE WELL M.D.
Preferred Provider Organization
11512 LAKE MEAD AVE, BUILDING 521
JACKSONVILLE, FL 32256
Duval County (904) 807-9747
MRS. ALISSA KIEHLE JONES CCC-SLP
Speech-Language Pathologist
11512 LAKE MEAD AVE, SUITE 203
JACKSONVILLE, FL 32256
Duval County (904) 652-5408
MICHELLE KLINDTWORTH CCC-SLP
Speech-Language Pathologist
11512 LAKE MEAD AVE, SUITE 203
JACKSONVILLE, FL 32256
Duval County (904) 652-5408

Frequently Asked Questions

What is CHARLES C GREENE MD PHD PA's NPI number?

The NPI number assigned to this healthcare provider is 1457600769, enumerated as an "organization" on August 31, 2012.

Where is the provider located?

The provider is located at 11512 LAKE MEAD AVE STE 531 JACKSONVILLE, FL 32256 and the phone number is (904) 419-2054.

What is the provider's specialty?

Otolaryngology with taxonomy code 207Y00000X.

What insurance does CHARLES C GREENE MD PHD PA accept?

The provider might be accepting Accepts: Ambetter from Superior HealthPlan, Ambetter. Please consult your insurance carrier or call the provider to verify.