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NPI 1629848866 · on the registry since 2024 · sole proprietor

Practice

Address
5959 Fort Caroline Rd Apt 3702
Jacksonville, FL 32277
Phone
(772) 333-5100
Organisation at this address
Crown Vision Community Home Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Registry record

Primary taxonomy
106S00000X
106S00000X
Also registered as
376K00000X
Licence states on file
FL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2025-12-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida