MEDICARE: WE CARE FAMILY CARE LLC

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	363L00000X	Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376258004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WE CARE FAMILY CARE LLC

Provider Business Mailing Address
First Line	:	3765 VICTORIA LAKES DR E
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32226-5881
Country	:	US
Telephone Number	:	904-933-8533
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 N NEWNAN ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32202-3121
Country	:	US
Telephone Number	:	904-933-8533
Fax Number	:

Authorized Official
Title or Position	:	NP/OWNER
Name	:	LASHENA JACKSON
Credential	:
Telephone Number	:	904-933-8533

Provider Enumeration Date	:	01/17/2023
Last Update Date	:	05/03/2023

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Directions to “WE CARE FAMILY CARE LLC ” Practice Location

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