Look up the most recent NPI and PECOS records

Justin Reid Federico

Hospitalist

Allopathic & Osteopathic Physicians

820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205

(904) 202-3860 (904) 202-2092

PECOS Enrollment

This provider is enrolled in PECOS as JUSTIN FEDERICO.

Based on the most recent information from CMS, provider Justin Reid Federico is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:21 AM.

Profile Details

Provider ID
1538327952
Provider Type
Individual
Full Name
Federico, Justin Reid
Credential
D.O.

Gender
Male
Sole Proprietor
No
Enumeration Date
6/2/2008
Last Updated
11/26/2024

Contact Information

Practice Location

820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205

(904) 202-3860

(904) 202-3846

Mailing Location

PO Box 746638, Atlanta, GA 30374-6638

(904) 202-2092

(904) 376-4075

Provider Taxonomies

Code	Description	License
Code 208M00000X Primary	Description Hospitalist Allopathic & Osteopathic Physicians	License OS11319 Florida
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License OS11319 Florida

Provider Identifiers

ID	Description	Issuer
ID 003631100	Description Medicaid	Issuer Unlisted Florida

Justin Reid Federico

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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Roemer, Amy Elizabeth

Abaaba, Vera Utagah

Patel, Tushar Mohanbhai

Maung, Toe Toe

Hu, Jenny

Sadic, Sahab Osama

Neuharth, Kristen Lynn

Rojas, Carlos

Ob Hospitalist Group Llc