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Jacksonville, FL 32231-0014 Section A Physician Information/ Requesting ProviderThank you for your participation! * Your assessment is very important for improving the workof artificial intelligence, which forms the content of this projectCMN_Ultrasound_in_Maternity_Care_Final Certificate of Medical Necessity: Ultrasounds in Maternity Care For Pre-Service: Statewide Fax (877) 219-9448 For Medicare Advantage (BlueMedicare) HMO and PPO Plans: Fax (904) 301-1614 Fax or mail this completed form to: For Post-Service Claims: Florida Blue P. com to submit Referrals and Authorizations. 826 Vaqueros St. Instructions Complete this fax cover sheet thoroughly including any additional information. P. For Post-Service Claims: Florida Blue. O. (904) 301-4247. O. The landline phone number 9043211614 is registered to Fock Toon Heng in Fernandina Beach, FL at 30520 Forest Parke Dr. Cellco Partnership Dba Verizon Wireless - Wa. Box 1798. O. 308-284-8083 fax . 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