MD2U FLORIDA LLC - NPI 1235422775 - Nurse Practitioner in Jacksonville, FL

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LG0600X and a focus in Gerontology.

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About Md2u Florida Llc NPPES

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

MD2U FLORIDA LLC (NPI 1235422775) is a healthcare organization registered as a gerontology in Jacksonville, Florida and active in the NPI registry since May 2011. The organization lists Gregory D. Latta, Cfo/cio, as its authorized official.

NPPES Registry Identity

NPI1235422775

Entity TypeOrganization

Primary Taxonomy363LG0600X

Legal Business NameMD2U FLORIDA LLC

Location Address10151 DEERWOOD PARK BLVD, 200-250Jacksonville, FL 32256-0566

Mailing AddressPo Box 7219Louisville, KY 40257-0219 · (502) 416-1851 · Fax (502) 416-1857

Phone(502) 327-9100

Fax(502) 742-3767

Organization SubpartYesParent: Md2u Management Llc

Authorized OfficialGregory D. LattaCfo/cio · (502) 416-1851

Enumeration DateMay 17, 2011

Last NPPES UpdateSeptember 25, 2012

✔ NPI 1235422775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

10151 DEERWOOD PARK BLVD, Jacksonville, FL 32256

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Other Identifiers 1

Other10D2045820FL · Clia - Certificate Of Waiver

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP