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

Jacksonville Otolaryngology & Facial Plastic Surgery

Organization Facial Plastic Surgery Physician · NPI 1306035951

Jacksonville Otolaryngology & Facial Plastic Surgery is a Facial Plastic Surgery 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

836 Prudential Dr Ste 807
Jacksonville, FL 32207-8335
Phone: (904) 396-8060
Fax: (904) 396-9700
Show map & directions

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

Specialties & licences

Facial Plastic Surgery Physician (primary) Taxonomy 207YS0123X · Licence ME #90519 (FL)

Record details

NPI number1306035951
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Juliann Cannon — Office Manager · (904) 396-8060
NPI enumeratedOctober 19, 2007
Last updated in NPPESOctober 19, 2007
Mailing address836 Prudential Dr Ste 807, Jacksonville, FL 32207-8335

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