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NPI Code Detail

MEDICARE: JOY DOMONDON FNP

MEDICARE: JOY DOMONDON FNP
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
1363LF0000XFamily Nurse Practitioner11026228FL

Other Identifiers

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

General Provider Information

NPI Number : 1427733526
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOY DOMONDON FNP
Provider Business Mailing Address
First Line : 1821 CAROLINA CHERRY WAY FL 32225
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-5375
Country : US
Telephone Number : 904-716-2496
Fax Number :
Provider Business Practice Location Address
First Line : 8351 WESTPORT RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32244-5901
Country : US
Telephone Number : 904-317-8811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2023
Last Update Date : 06/16/2023

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