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NPI 1962373902

NPI 1962373902 : PRESTIGE PATIENT CARE : JACKSONVILLE, FL

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General NPI Number Information
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    NPI Number           |    1962373902
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    Entity Type          |    Organization 
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    Legal Business Name  |    PRESTIGE PATIENT CARE 
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Dates
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    Enumeration Date     |    09/15/2025
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    Last Update Date     |    09/15/2025
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Provider Practice Location Address
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    Address Line         |    9506 ABERDARE AVE W 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32208-1103
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    Country              |    US
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    Telephone            |    904-662-8643
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    Fax                  |    904-662-8643
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Provider Business Mailing Address
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    Address Line         |    9506 ABERDARE AVE W 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32208-1103
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    Country              |    US
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    Telephone            |    904-662-8643
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    Fax                  |    904-662-8643
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     FELECIA  THOMPSON 
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    Credential           |    
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    Telephone            |    904-662-8643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    385H00000X
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    Taxonomy Name        |    Respite Care
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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        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    
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    License Number State |    
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