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NPI Code Detail

MEDICARE: LAURA GHASSEMINIA

MEDICARE:   LAURA  GHASSEMINIA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerARNP9383728FL

General Provider Information

NPI Number : 1700329026
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA GHASSEMINIA
Provider Business Mailing Address
First Line : 11820 HEATHER GROVE LN
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32223-1954
Country : US
Telephone Number : 904-568-8969
Fax Number :
Provider Business Practice Location Address
First Line : 2320 3RD ST S STE 1
Second Line :
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-4057
Country : US
Telephone Number : 904-339-8204
Fax Number : 904-217-5104
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2016
Last Update Date : 02/29/2024

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Directions to “ LAURA GHASSEMINIA ” Practice Location

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