MEDICARE: NURSING ON DEMAND PRIMARY CARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1346932076
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NURSING ON DEMAND PRIMARY CARE, INC

Provider Business Mailing Address
First Line	:	4401 EMERSON ST STE 8
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-4954
Country	:	US
Telephone Number	:	904-387-9406
Fax Number	:	904-212-0381

Provider Business Practice Location Address
First Line	:	4401 EMERSON ST STE 8
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-4954
Country	:	US
Telephone Number	:	904-387-9406
Fax Number	:	904-212-0381

Authorized Official
Title or Position	:	OWNER APRN
Name	:	MR. BRANDON N HILLARD
Credential	:	APRN, FNP-BC
Telephone Number	:	904-662-4853

Provider Enumeration Date	:	05/22/2023
Last Update Date	:	05/22/2023

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