Healthcare Provider Details

I. General information

NPI: 1710700430
Provider Name (Legal Business Name): GEZIM PAJAZITI APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 ASHOURIAN AVE STE 105
ST AUGUSTINE FL
32092-5110
US

IV. Provider business mailing address

PO BOX 100237
GAINESVILLE FL
32610-0237
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-1006
  • Fax: 904-819-1008
Mailing address:
  • Phone: 352-392-4541
  • Fax: 352-294-8519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11033420
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11033420
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: