Healthcare Provider Details

I. General information

NPI: 1306327465
Provider Name (Legal Business Name): THE LJB GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 08/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1261 DELFINO DR
JACKSONVILLE FL
32225-5435
US

IV. Provider business mailing address

1261 DELFINO DR
JACKSONVILLE FL
32225-5435
US

V. Phone/Fax

Practice location:
  • Phone: 904-382-8439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Y00000X
TaxonomyHealth Information Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: LARRY LONGHI
Title or Position: PRESIDENT & CEO
Credential:
Phone: 904-382-8439