| Mielke Group, Inc. | |
|
3 Shircliff Way Suite #333 Jacksonville FL 32204-4757 | |
| (904) 607-2079 | |
| (904) 384-0094 |
| Full Name | Mielke Group, Inc. |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 3 Shircliff Way, Jacksonville, Florida |
| Authorized Official Name and Position | Jeannine B. Mielke (OWNER) |
| Authorized Official Contact | 9046072079 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mielke Group, Inc. 7177 Augusta Dr Fleming Island FL 32003-8755 Ph: (904) 607-2079 | Mielke Group, Inc. 3 Shircliff Way Suite #333 Jacksonville FL 32204-4757 Ph: (904) 607-2079 |
| NPI Number | 1013161223 |
|---|---|
| Provider Enumeration Date | 11/14/2008 |
| Last Update Date | 08/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013161223 | NPI | - | NPPES |
| 74187 | Other | FL | BLUE CROSS AND BLUE SHIELD OF FLORIDA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PY6839 (Florida) | Primary |
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