Healthcare Provider Details

I. General information

NPI: 1588570535
Provider Name (Legal Business Name): KEYS TO THE HEART HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4190 PLANTATION OAKS BLVD UNIT 941
ORANGE PARK FL
32065-3538
US

IV. Provider business mailing address

4190 PLANTATION OAKS BLVD UNIT 941
ORANGE PARK FL
32065-3538
US

V. Phone/Fax

Practice location:
  • Phone: 904-891-8830
  • Fax: 904-891-8830
Mailing address:
  • Phone: 904-891-8830
  • Fax: 904-891-8830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MS. NATOSHIA GAINES
Title or Position: CO-OWNER
Credential:
Phone: 904-891-8830