Healthcare Provider Details

I. General information

NPI: 1508794587
Provider Name (Legal Business Name): JANIE BUNNI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6206 ATLANTIC BLVD STE 1
JACKSONVILLE FL
32211-7560
US

IV. Provider business mailing address

12060 WREN HOLLOW CT
JACKSONVILLE FL
32246-7788
US

V. Phone/Fax

Practice location:
  • Phone: 904-731-3141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF07261249
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: