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

Jacksonville Impotence Treatment Center

Organization Clinic/Center · NPI 1508893579

Jacksonville Impotence Treatment Center is a Clinic/Center in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006

Practice location Address checks out

2950 Halcyon Lane SUITE706
Jacksonville, FL 32223
Phone: (904) 880-1366
Fax: (904) 880-8038
Show map & directions

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

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X · Licence ME0053960 (FL)

Record details

NPI number1508893579
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roger Miller — President., Jitc · (904) 880-1366
Other names Jitc
NPI enumeratedJune 27, 2006
Last updated in NPPESMarch 31, 2008
Mailing address2950 Halcyon Lane, Suite706, Jacksonville, FL 32223

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