Healthcare Provider Details

I. General information

NPI: 1558297887
Provider Name (Legal Business Name): DOVEZ NEST HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 MESSINA DR
SAINT AUGUSTINE FL
32092-4516
US

IV. Provider business mailing address

4110 MESSINA DR
SAINT AUGUSTINE FL
32092-4516
US

V. Phone/Fax

Practice location:
  • Phone: 904-615-7719
  • Fax: 321-256-6240
Mailing address:
  • Phone: 904-615-7719
  • Fax: 321-256-6240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: DR. DIANA PATRICE JORDAN-BALDWIN
Title or Position: OWNER
Credential:
Phone: 904-615-7719