JACKSONVILLE CHILDREN'S SURGERY CENTER, LLC
NPI 1770620742
Clinic/Center - Ambulatory Surgical in Jacksonville, FL

Active since January 31, 2007CLIA 10D2005614 · Waiver
3599 UNIVERSITY BLVD S STE 604, JACKSONVILLE, FL 32216(904) 525-8629 Get Directions Write a Review

NPPES record last updated: January 27, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 15, 2022, Mar 9, 2022, Nov 22, 2021 (3 updates tracked since 2021).

About Jacksonville Children's Surgery Center, Llc NPPES

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

JACKSONVILLE CHILDREN'S SURGERY CENTER, LLC (NPI 1770620742) is a healthcare organization registered as an ambulatory surgical in Jacksonville, Florida and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through March 30, 2028 and lists Devin Larsen, Ceo, as its authorized official.

NPPES Registry Identity

NPI1770620742
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameJACKSONVILLE CHILDREN'S SURGERY CENTER, LLC
Location Address3599 UNIVERSITY BLVD S STE 604Jacksonville, FL 32216-4234
Mailing Address9709 Lakeside Blvd Ste 350Spring, TX 77381-1213 · (713) 489-2198 · Fax (713) 489-2978
Organization SubpartNo
Authorized OfficialDevin LarsenCeo · (208) 340-1840
Enumeration DateJanuary 31, 2007
Last NPPES UpdateJanuary 27, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 27, 2025
NPI 1770620742 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
License Licensed in FL · 390
3599 UNIVERSITY BLVD S STE 604, Jacksonville, FL 32216

Other Identifiers 1

Other683FL · Blue Cross Blue Shield

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2005614

Jacksonville Children's Surgery Center, LLC · Jacksonville, FL
Active · expires Mar 30, 2028
CLIA Number10D2005614
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateMarch 31, 2026
Certificate Expiration DateMarch 30, 2028
Laboratory DirectorKevin Cleave
Laboratory Phone(904) 525-8629
Laboratory LocationJacksonville Children's Surgery Center, LLC3599 University Blvd S Ste 604, Jacksonville, FL 32216
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

Clinic/Center (Ambulatory Surgical)
3599 UNIVERSITY BLVD S STE 604
JACKSONVILLE, FL 32216
Anesthesiology
3599 UNIVERSITY BLVD S STE 604
JACKSONVILLE, FL 32216
Dentist (Pediatric Dentistry)
3599 UNIVERSITY BLVD S STE 604
JACKSONVILLE, FL 32216
Nurse Anesthetist, Certified Registered
3599 UNIVERSITY BLVD S STE 604
JACKSONVILLE, FL 32216

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 Jacksonville Children's Surgery Center, LLC's NPI number?

The NPI number for Jacksonville Children's Surgery Center, LLC is 1770620742. It was assigned to this organization in the NPPES registry on January 31, 2007.

Where is Jacksonville Children's Surgery Center, LLC located?

Jacksonville Children's Surgery Center, LLC is located at 3599 University Blvd S Ste 604, Jacksonville, FL 32216. The listed phone number is (904) 525-8629.

What is Jacksonville Children's Surgery Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Jacksonville Children's Surgery Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2005614) is associated with this NPI, valid through March 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Jacksonville Children's Surgery Center, LLC accept?

Health plans from Molina Healthcare list Jacksonville Children's Surgery Center, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacksonville Children's Surgery Center, LLC was last updated on January 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.