NPI 1629414479

Kpncinc

Organisation Nursing Facility/Intermediate Care Facility Jacksonville, FL

Practice location

Address: 764 Aqua Surf CT, Jacksonville, FL 32225-0802
Phone: (904) 554-6051
Fax: (904) 361-3235

Authorised official

Name: Agelet St Hubert
Title: Owner/President
Phone: (904) 554-6051

Registered specialties

Nursing Facility/Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 313M00000X Licence 6906603 (FL)

Other Nursing Facility/Intermediate Care Facility providers in Florida →

Registry record

NPI: 1629414479
Entity type: Organization
NPI issued: 21 May 2013
Record last updated: 21 May 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.