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NPI 1184958910ActiveOrganization· Preferred Provider Organization· Fernandina Beach, FL

Preferred Provider Organization in Fernandina Beach, Florida, registered in NPPES in September 2009. The authorized official on file is Dominic Brown, President.

Overview

NPI1184958910
StatusActive
Entity typeOrganization
NPI issuedSep 27, 2009
Last updated in NPPESSep 27, 2009

Specialties and licenses

TaxonomyCodeLicenseState
Preferred Provider Organization Primary305R00000X—FL

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years