Healthcare Provider Details

I. General information

NPI: 1295216414
Provider Name (Legal Business Name): ASHLEY BALDWIN VANJARIA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY ELIZABETH BALDWIN DNP

II. Dates (important events)

Enumeration Date: 08/25/2018
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SAN BARTOLA DR
ST AUGUSTINE FL
32086-5767
US

IV. Provider business mailing address

15280 NW 79TH CT STE 200
MIAMI LAKES FL
33016-5873
US

V. Phone/Fax

Practice location:
  • Phone: 904-823-8823
  • Fax: 904-808-1505
Mailing address:
  • Phone: 305-558-3724
  • Fax: 786-907-4485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9248022
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number9248022
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9248022
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: