| Islimlipo | |
|
4540 Southside Blvd Ste 401 Jacksonville FL 32216-5488 | |
| (772) 281-7682 | |
| Not Available |
| Full Name | Islimlipo |
|---|---|
| Speciality | Clinic/Center |
| Location | 4540 Southside Blvd Ste 401, Jacksonville, Florida |
| Authorized Official Name and Position | Allison Kern (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 7722817682 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Islimlipo 4540 Southside Blvd Ste 401 Jacksonville FL 32216-5488 Ph: (772) 281-7682 | Islimlipo 4540 Southside Blvd Ste 401 Jacksonville FL 32216-5488 Ph: (772) 281-7682 |
| NPI Number | 1801409909 |
|---|---|
| Provider Enumeration Date | 08/28/2020 |
| Last Update Date | 09/18/2020 |
| Medicare PECOS PAC ID | 3375962137 |
|---|---|
| Medicare Enrollment ID | O20200928001710 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801409909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Augusto De Leon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982664165 PECOS PAC ID: 1850372269 Enrollment ID: I20040601000079 |
| Provider Name | Mary K Schupp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851445860 PECOS PAC ID: 0840210969 Enrollment ID: I20051202000635 |
| Provider Name | Catherine Odom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740526649 PECOS PAC ID: 6709030844 Enrollment ID: I20130125000314 |
| Provider Name | Jennifer Margo Greenfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881980043 PECOS PAC ID: 6305073578 Enrollment ID: I20170301001762 |
| Provider Name | Sheryl Ann Meeuwsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730658790 PECOS PAC ID: 6406181015 Enrollment ID: I20190718000092 |
| Provider Name | Rebecca E Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346633393 PECOS PAC ID: 9335449107 Enrollment ID: I20200205002177 |
| Provider Name | Daisy Cuc Tu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467038802 PECOS PAC ID: 6002223203 Enrollment ID: I20210407000172 |
| Provider Name | Odessa Doucet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508438557 PECOS PAC ID: 0143623553 Enrollment ID: I20210722002928 |
| Provider Name | Shana Mccloud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679150338 PECOS PAC ID: 5799188520 Enrollment ID: I20210730000996 |
| Provider Name | Beverly Danielle Milford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205509130 PECOS PAC ID: 2264830629 Enrollment ID: I20211122002385 |
| Provider Name | Guerline Saintfleur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184209579 PECOS PAC ID: 8527446624 Enrollment ID: I20220601002748 |
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