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General NPI Number Information
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NPI Number | 1770963019
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Entity Type | Organization
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Legal Business Name | LADY SPEARHEAD, LLC
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 10033 SAWGRASS DR W SUITE 209
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City | PONTE VEDRA BEACH
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State | FL
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Zip | 32082-3564
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Country | US
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Telephone | 904-834-2474
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Fax |
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Provider Business Mailing Address
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Address Line | 10033 SAWGRASS DR W UNIT 209
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City | PONTE VEDRA BEACH
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State | FL
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Zip | 32082-3550
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | JAYNE BOGDAJEWICZ
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Credential |
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Telephone | 904-834-2474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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