Healthcare Provider Details

I. General information

NPI: 1457282469
Provider Name (Legal Business Name): ISABELLA VIGNALI DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4540 SOUTHSIDE BLVD STE 1101
JACKSONVILLE FL
32216-5495
US

IV. Provider business mailing address

4540 SOUTHSIDE BLVD STE 1101
JACKSONVILLE FL
32216-5495
US

V. Phone/Fax

Practice location:
  • Phone: 904-988-3887
  • Fax:
Mailing address:
  • Phone: 904-988-3887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number15911
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: