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General NPI Number Information
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NPI Number | 1912799396
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Entity Type | Organization
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Legal Business Name | ROYAL CARDINAL CARE CORPORATION
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 11000 BEACH BLVD STE 201
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City | JACKSONVILLE
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State | FL
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Zip | 32246-9904
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Country | US
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Telephone | 904-624-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 11000 BEACH BLVD STE 201
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City | JACKSONVILLE
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State | FL
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Zip | 32246-9904
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Country | US
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Telephone | 904-624-9000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER PASTEUR
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Credential | MED
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Telephone | 904-624-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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