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Contact Information

5JAGHEALTH, PLLC
112 IRVIN AVE SW
LIVE OAK, FL32064-2214
 Phone: 386-647-6144
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for 5JAGHEALTH, PLLC

NPI # 1407636582
LBN Legal business name 5JAGHEALTH, PLLC
Authorized official AYMEE WILSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/04/2023
Last updated 02/08/2024 - About 2 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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