Healthcare Provider Details

I. General information

NPI: 1740197755
Provider Name (Legal Business Name): JEMIMA PAYNE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 BRAZIL NUT CIR
JACKSONVILLE FL
32218-1992
US

IV. Provider business mailing address

165 BRAZIL NUT CIR
JACKSONVILLE FL
32218-1992
US

V. Phone/Fax

Practice location:
  • Phone: 904-525-6911
  • Fax:
Mailing address:
  • Phone: 904-525-6911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: