PROACTIVE HEALTH OF MANDARIN LLC NPI 1639542384

NPI Information

NPI: 1639542384
Provider Name: PROACTIVE HEALTH OF MANDARIN LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
12428 SAN JOSE BLVD STE 2
JACKSONVILLE, FL
ZIP 32223
Phone: (904) 704-3683
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PROACTIVE HEALTH OF MANDARIN LLC is a health service clinic center in Jacksonville, FL. PROACTIVE HEALTH OF MANDARIN LLC NPI is 1639542384. The provider is registered as an organization entity type.

The provider's business location address is:

12428 SAN JOSE BLVD STE 2
JACKSONVILLE, FL
ZIP 32223-617
Phone: (904) 704-3683
Fax: (904) 288-8995

The provider's authorized official is April Deann Swanstrom .
The authorized official title is Chiropractic Physician and has the following contact phone number (904) 704-3683.

The enumeration date for this NPI number is 11/3/2015 and was last updated on 11/3/2015.

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	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	CH11696	FLORIDA	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: 4/28/2024

NPI Synchronization or Removal

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