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General NPI Number Information
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NPI Number | 1588588602
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Entity Type | Organization
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Legal Business Name | BOLD HEALTHCARE PLLC
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Dates
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Enumeration Date | 08/10/2026
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Last Update Date | 08/10/2026
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Provider Practice Location Address
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Address Line | 2802 PARENTAL HOME RD
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City | JACKSONVILLE
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State | FL
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Zip | 32216-5702
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Country | US
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Telephone | 904-881-4520
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Fax |
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Provider Business Mailing Address
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Address Line | 7857 RITTENHOUSE LN
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City | JACKSONVILLE
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State | FL
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Zip | 32256-3631
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Country | US
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Telephone | 904-881-4520
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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. YACOB HABBOUSH
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Credential | MD
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Telephone | 904-881-4520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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