Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fruit Cove Family Medicine P A

Organization Family Medicine Physician · NPI 1629195300

Fruit Cove Family Medicine P A is a Family Medicine Physician in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in
FL
In the registry since
2007

Practice location Address checks out

1400 Bishop Estates Rd
Jacksonville, FL 32259-4244
Phone: (904) 287-2794
Fax: (904) 287-5362
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence ME69268 (FL)

Record details

NPI number1629195300
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Levine — President · (904) 287-2794
NPI enumeratedMarch 26, 2007
Last updated in NPPESAugust 22, 2020
Mailing address1400 Bishop Estates Rd, Jacksonville, FL 32259-4244

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