MEDICARE: HOUSE OF TRAP 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	171W00000X	Contractor

General Provider Information

NPI Number	:	1437012093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSE OF TRAP LLC

Provider Business Mailing Address
First Line	:	1274 STATE ST W STE B
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-1046
Country	:	US
Telephone Number	:	904-537-2287
Fax Number	:

Provider Business Practice Location Address
First Line	:	1274 STATE ST W STE B
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-1046
Country	:	US
Telephone Number	:	904-537-2287
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JABRIL ABDULLAH
Credential	:
Telephone Number	:	904-537-2287

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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Directions to “HOUSE OF TRAP LLC ” Practice Location

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