OrganizationActive
Jacksonville Impotence Treatment Center
NPI 1508893579 · Clinic/Center · Jacksonville, FL
Provider details
- NPI number
- 1508893579
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Roger Miller, President., Jitc(904) 880-1366
- License
- ME0053960 (FL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
2950 Halcyon Lane
Suite706
Jacksonville, FL 32223
Phone: (904) 880-1366
Fax: (904) 880-8038
Street-level locationGet directions
Mailing address
2950 Halcyon Lane
Jacksonville, FL 32223
Other names (DBA / former)
- Doing business as
- Jitc
Registry dates
- Enumerated
- 2006-06-27
- Last updated
- 2008-03-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.