Healthcare Provider Details

I. General information

NPI: 1285505586
Provider Name (Legal Business Name): STUART PAIGE ASBURY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13904 ATLANTIC BLVD
JACKSONVILLE FL
32225-3241
US

IV. Provider business mailing address

13904 ATLANTIC BLVD
JACKSONVILLE FL
32225-3241
US

V. Phone/Fax

Practice location:
  • Phone: 904-319-1204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License NumberOT22870
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: