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General NPI Number Information
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NPI Number | 1609689173
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Entity Type | Organization
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Legal Business Name | SEASIDE GEMS LLC
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 446 3RD ST STE 10
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266-5111
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Country | US
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Telephone | 904-339-2289
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Fax |
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Provider Business Mailing Address
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Address Line | 446 3RD ST STE 10
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266-5111
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Country | US
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Telephone | 904-339-2289
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED MEMBER (OWNER)
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Name | GEMMA CHINLOY
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Credential |
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Telephone | 904-339-2289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SH0200X
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Taxonomy Name | Home Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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