Healthcare Provider Details

I. General information

NPI: 1609528488
Provider Name (Legal Business Name): READ REFLECT & REPAIR HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2022
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

669 KINGSLEY AVE
ORANGE PARK FL
32073-5467
US

IV. Provider business mailing address

4492 STEAMBOAT SPRINGS DR E
JACKSONVILLE FL
32210-1406
US

V. Phone/Fax

Practice location:
  • Phone: 904-801-7899
  • Fax:
Mailing address:
  • Phone: 904-482-8301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASMINE SEARA HARDAWAY
Title or Position: CEO
Credential: RN
Phone: 904-482-8301