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General NPI Number Information
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NPI Number | 1508759176
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Entity Type | Organization
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Legal Business Name | VERNELL KING ENTERPRISE LLC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 1100 KINGS RD UNIT 2785
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City | JACKSONVILLE
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State | FL
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Zip | 32203
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Country | US
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Telephone | 561-358-2049
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 KINGS RD UNIT 2785
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City | JACKSONVILLE
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State | FL
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Zip | 32203
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Country | US
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Telephone | 904-467-0737
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. VERNELL KING
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Credential | PHD
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Telephone | 561-358-2049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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