Healthcare Provider Details

I. General information

NPI: 1225409725
Provider Name (Legal Business Name): ALICIA F GRIFFIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2015
Last Update Date: 10/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7406 FULLERTON ST SUITE 2000
JACKSONVILLE FL
32256-3552
US

IV. Provider business mailing address

8007 HANCOCK ST
RIVERVIEW FL
33578-4462
US

V. Phone/Fax

Practice location:
  • Phone: 904-538-0440
  • Fax:
Mailing address:
  • Phone: 813-690-3257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9308382
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: