Basic Information
| Provider Information | |||||||||
| NPI: | 1023081700 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAMES | ||||||||
| FirstName: | HECTOR | ||||||||
| MiddleName: | EDWARD | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 44008 | ||||||||
| Address2: | UFJP NEUROSURGERY - PEDIATRICS | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322314008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043985201 | ||||||||
| FaxNumber: | 9042443425 | ||||||||
| Practice Location | |||||||||
| Address1: | 836 PRUDENTIAL DR | ||||||||
| Address2: | UFJP NEUROSURGERY - PEDIATRICS | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322078337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043985201 | ||||||||
| FaxNumber: | 9042443425 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2006 | ||||||||
| LastUpdateDate: | 09/03/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | ME91626 | FL | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 2680084-00 | 05 | FL | MEDICAID | 348000736A | 05 | GA | MEDICAID |