FIRST COAST CARDIOVASCULAR SURGICAL CENTER, LLC
NPI 1912661133
Clinic/Center - Ambulatory Surgical in Jacksonville, FL

NPI Status: Active since October 25, 2021

Contact Information

7011 A C SKINNER PKWY STE 170
JACKSONVILLE, FL
ZIP 32256
Phone: (904) 493-3333
Fax: (904) 493-2222

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 10D2094857
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 04-26-2027

About FIRST COAST CARDIOVASCULAR SURGICAL CENTER, LLC

This page provides the complete NPI Profile along with additional information for First Coast Cardiovascular Surgical Center, Llc, a provider established in Jacksonville, Florida operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1912661133 assigned on October 2021. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Yazan Khatib Md (President)

NPI
1912661133
Provider Name
FIRST COAST CARDIOVASCULAR SURGICAL CENTER, LLC
Entity Type
Organization
Location Address
7011 A C SKINNER PKWY STE 170 JACKSONVILLE, FL 32256
Location Phone
(904) 493-3333
Location Fax
(904) 493-2222
Mailing Address
PO BOX 551308 JACKSONVILLE, FL 32255
Mailing Phone
(904) 493-3333
Mailing Fax
(904) 493-2222
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-25-2021
Last Update Date
03-18-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

YAZAN KHATIB MD

Authorized Official Title
PRESIDENT
Authorized Official Phone
(904) 493-3333

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D2094857
Facility Type
Physician Office
Certificate Effective Date
April 27, 2025
Certificate Expiration Date
April 26, 2027
Laboratory Director
YAZAN KHATIB
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to First Coast Cardiovascular Surgical Center, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1912661133, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
1
Doubled → 2
Pos 4
2
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
6
Unchanged
Pos 7
1
Doubled → 2
Pos 8
1
Unchanged
Pos 9
3
Doubled → 6
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 6 → 12 → 3 1 → 2 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 2 + 2 + 1 + 2 + 6 + 2 + 1 + 6 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1912661133.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1912661133, enumerated as an "organization" on October 25, 2021.

The provider is located at 7011 A C SKINNER PKWY STE 170 JACKSONVILLE, FL 32256 and the phone number is (904) 493-3333.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.