Healthcare Provider Details

I. General information

NPI: 1275005597
Provider Name (Legal Business Name): JASMINE FLOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2018
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5776 SAINT AUGUSTINE RD
JACKSONVILLE FL
32207-8030
US

IV. Provider business mailing address

1680 WILD DUNES CIR
ORANGE PARK FL
32065-2621
US

V. Phone/Fax

Practice location:
  • Phone: 904-448-4700
  • Fax:
Mailing address:
  • Phone: 904-885-8085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH24881
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: