MEDICARE: ELITE MIND AND BODY SOLUTIONS

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1760147839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE MIND AND BODY SOLUTIONS

Provider Business Mailing Address
First Line	:	7643 GATE PKWY UNIT 104-311
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-2893
Country	:	US
Telephone Number	:	904-400-2206
Fax Number	:

Provider Business Practice Location Address
First Line	:	11396 NETTLEBROOK ST E
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-1005
Country	:	US
Telephone Number	:	904-400-2206
Fax Number	:

Authorized Official
Title or Position	:	FAMILY AND PSYCH NURSE PRACTITIONER
Name	:	DR. PAULA YVETTE PARSONS
Credential	:	DNP,MSHL,MSN,APRN
Telephone Number	:	904-400-2206

Provider Enumeration Date	:	11/03/2021
Last Update Date	:	11/03/2021

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Directions to “ELITE MIND AND BODY SOLUTIONS ” Practice Location

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