MEDICARE: ALL ONE LIFE 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	332BC3200X	Customized Equipment (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1881425932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL ONE LIFE LLC

Provider Business Mailing Address
First Line	:	6501 ARLINGTON EXPY # B1052208
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-5779
Country	:	US
Telephone Number	:	321-710-6568
Fax Number	:

Provider Business Practice Location Address
First Line	:	6501 ARLINGTON EXPY STE B1052208
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-5779
Country	:	US
Telephone Number	:	321-710-6568
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. SHERELL EDWARDS
Credential	:	ED.D
Telephone Number	:	321-710-6568

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	08/12/2024

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Directions to “ALL ONE LIFE LLC ” Practice Location

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