SOUTHBRDGE HEALTH AND WELLNESS LLC NPI 1043089998

NPI Information

NPI: 1043089998
Provider Name: SOUTHBRDGE HEALTH AND WELLNESS LLC
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Organization

Specialization: Adult Health

Address:
476 RIVERSIDE AVE # 1905
JACKSONVILLE, FL
ZIP 32202
Phone: (904) 800-9220
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SOUTHBRDGE HEALTH AND WELLNESS LLC is an adult health nurse practitioner in Jacksonville, FL. SOUTHBRDGE HEALTH AND WELLNESS LLC NPI is 1043089998. The provider is registered as an organization entity type.

The provider's business location address is:

476 RIVERSIDE AVE # 1905
JACKSONVILLE, FL
ZIP 32202-912
Phone: (904) 800-9220
Fax: (904) 674-1843

The provider's authorized official is Dora Agyei Agyemang .
The authorized official title is Owner and has the following contact phone number (912) 800-9220.

The enumeration date for this NPI number is 12/20/2023 and was last updated on 12/20/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	251B00000X	Case Management		No
2	251E00000X	Home Health		No
3	261Q00000X	Clinic/Center		No
4	261QI0500X	Clinic/Center	Infusion Therapy	No
5	261QR1300X	Clinic/Center	Rural Health	No
6	363LA2200X	Nurse Practitioner	Adult Health	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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