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SOUTHBRDGE HEALTH AND WELLNESS LLC
NPI 1043089998
Nurse Practitioner - Adult Health in Jacksonville, FL

Active since December 20, 2023
476 RIVERSIDE AVE # 1905, JACKSONVILLE, FL 32202(904) 800-9220(904) 674-1843 Get Directions Write a Review

NPPES record last updated: December 20, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southbrdge Health And Wellness Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHBRDGE HEALTH AND WELLNESS LLC (NPI 1043089998) is a healthcare organization registered as an adult health in Jacksonville, Florida and active in the NPI registry since December 2023. The organization lists Dora Agyei Agyemang, Owner, as its authorized official.

NPPES Registry Identity

NPI1043089998
Entity TypeOrganization
Primary Taxonomy363LA2200X
Legal Business NameSOUTHBRDGE HEALTH AND WELLNESS LLC
Location Address476 RIVERSIDE AVE # 1905Jacksonville, FL 32202-4912
Mailing Address851 Southbridge BlvdSavannah, GA 31405-1096 · (912) 657-5256
Phone(904) 800-9220
Fax(904) 674-1843
Organization SubpartNo
Authorized OfficialDora Agyei AgyemangOwner · (912) 800-9220
Enumeration DateDecember 20, 2023
NPPES CertifiedDecember 19, 2023
✔ NPI 1043089998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
Also ListedCase ManagementTaxonomy 251B00000X
Also ListedHome HealthTaxonomy 251E00000X
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedClinic/Center · Infusion TherapyTaxonomy 261QI0500X
Also ListedClinic/Center · Rural HealthTaxonomy 261QR1300X
476 RIVERSIDE AVE # 1905, Jacksonville, FL 32202
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southbrdge Health And Wellness LLC's NPI number?

The NPI number for Southbrdge Health And Wellness LLC is 1043089998. It was assigned to this organization in the NPPES registry on December 20, 2023.

Where is Southbrdge Health And Wellness LLC located?

Southbrdge Health And Wellness LLC is located at 476 Riverside Ave # 1905, Jacksonville, FL 32202. The listed phone number is (904) 800-9220.

What is Southbrdge Health And Wellness LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

When was this NPI record last updated?

The NPPES record for Southbrdge Health And Wellness LLC was last updated on December 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.