Eric Alee Vance Qualkenbush, - Medicare Urology in Jacksonville, FL

Eric Alee Vance Qualkenbush, is a medicare enrolled "Urology" physician in Jacksonville, Florida. His current practice location is 4500 San Pablo Rd S, Jacksonville, Florida. You can reach out to his office (for appointments etc.) via phone at (904) 953-2000.

Eric Alee Vance Qualkenbush is licensed to practice in Florida (license number TRN35501) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1033865480.

Contact Information

Eric Alee Vance Qualkenbush,
4500 San Pablo Rd S,
Jacksonville, FL 32224-1865
(904) 953-2000
Not Available



Physician's Profile

Full NameEric Alee Vance Qualkenbush
GenderMale
SpecialityUrology
Location4500 San Pablo Rd S, Jacksonville, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1033865480
  • Provider Enumeration Date: 02/24/2022
  • Last Update Date: 06/29/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 3779963517
  • Enrollment ID: I20220711001220

Medical Identifiers

Medical identifiers for Eric Alee Vance Qualkenbush such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033865480NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208800000XUrology TRN35501 (Florida)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Eric Alee Vance Qualkenbush is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Eric Alee Vance Qualkenbush,
4500 San Pablo Rd S,
Jacksonville, FL 32224-1865

Ph: (904) 953-2000
Eric Alee Vance Qualkenbush,
4500 San Pablo Rd S,
Jacksonville, FL 32224-1865

Ph: (904) 953-2000

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Urology Doctors in Jacksonville, FL

Amanda Elizabeth Kahn, MD
Urology
Medicare: Medicare Enrolled
Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224
Phone: 904-953-2000    
Sarah Jessica Hampton,
Urology
Medicare: Medicare Enrolled
Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224
Phone: 904-953-2000    
Daniela Andrea Haehn, MD
Urology
Medicare: Medicare Enrolled
Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224
Phone: 904-953-2000    
Charles Gary Cobb, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 710 Lomax St, Jacksonville, FL 32204
Phone: 904-355-6583    Fax: 904-355-4922
Gregory Broderick, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224
Phone: 904-953-2000    
Dr. Erica S. Mercer, MD
Urology
Medicare: Medicare Enrolled
Practice Location: 807 Childrens Way, Jacksonville, FL 32207
Phone: 904-390-3747    Fax: 904-390-3429

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