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

Jacksonville Physical Medicine LLC

Organization Internal Medicine Physician · NPI 1205174695

Jacksonville Physical Medicine LLC is an Internal Medicine Physician in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2013.

Licensed in
FL
In the registry since
2013
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

7860 Gate Pkwy Ste 106
Jacksonville, FL 32256-7280
Phone: (904) 619-2703
Fax: (904) 619-2837
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence ME88018 (FL)
Nurse Practitioner Taxonomy 363L00000X · Licence ARNP9278608 (FL)

Record details

NPI number1205174695
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeremiah Carlson — Owner · (904) 619-2703
NPI enumeratedJanuary 21, 2013
Last updated in NPPESJanuary 21, 2013
Mailing address7860 Gate Pkwy Ste 106, Jacksonville, FL 32256-7280

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