OrganizationActive
Ips of Jacksonville LLC
NPI 1417192022 · Ambulatory Surgical Clinic/Center · Bradenton, FL
Provider details
- NPI number
- 1417192022
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Carl Noback, Member(941) 360-1566
- License
- 1176 (FL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4754 E State Road 64
Bradenton, FL 34208-9058
Phone: (888) 337-3509
Fax: (941) 328-3997
Street-level locationGet directions
Mailing address
Po Box 864483
Orlando, FL 32886-4483
Registry dates
- Enumerated
- 2008-12-10
- Last updated
- 2017-01-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.