MEDICARE: FLORIDA OCD AND ANXIETY SPECIALISTS, 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1811850761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA OCD AND ANXIETY SPECIALISTS, LLC

Provider Business Mailing Address
First Line	:	7643 GATE PKWY STE 104-1211
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-3092
Country	:	US
Telephone Number	:	904-410-7010
Fax Number	:	754-732-8118

Provider Business Practice Location Address
First Line	:	4400 MARSH LANDING BLVD STE 104
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32082-1287
Country	:	US
Telephone Number	:	904-410-7010
Fax Number	:	754-732-8118

Authorized Official
Title or Position	:	OWNER
Name	:	GINNA G. OSPINA
Credential	:	LMHC
Telephone Number	:	904-410-7010

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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