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General NPI Number Information
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NPI Number | 1700329026
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Entity Type | Individual
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Provider Name | LAURA GHASSEMINIA
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Gender | Female
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Dates
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Enumeration Date | 11/18/2016
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 2320 3RD ST S STE 1
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4057
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Country | US
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Telephone | 904-339-8204
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Fax | 904-217-5104
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Provider Business Mailing Address
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Address Line | 11820 HEATHER GROVE LN
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City | JACKSONVILLE
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State | FL
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Zip | 32223-1954
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Country | US
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Telephone | 904-568-8969
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9383728
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License Number State | FL
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