Healthcare Provider Details

I. General information

NPI: 1336104975
Provider Name (Legal Business Name): FIVE POINTS HEALTHCARE LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11411 ARMSDALE RD
JACKSONVILLE FL
32218-3311
US

IV. Provider business mailing address

11411 ARMSDALE RD
JACKSONVILLE FL
32218-3311
US

V. Phone/Fax

Practice location:
  • Phone: 904-714-3793
  • Fax: 904-714-3799
Mailing address:
  • Phone: 904-714-3793
  • Fax: 904-714-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateFL

VIII. Authorized Official

Name: LANELLE NATHEY MCDONALD
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 904-714-3793