OLIVIA MICHELLE BULLOCK (NPI# 1114542859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114542859 |
Entity Type | Individual |
Full Name | OLIVIA MICHELLE BULLOCK |
Credential | DO |
Practice Address |
2627 Riverside Ave Jacksonville FL 32204-4717 |
Practice Telephone | 9043087372 |
Mailing Telephone | 9043087372 |
Enumeration Date | 2020-06-09 |
Last Update Date | 2020-06-09 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | UO7189 | FL | Student, Health Care |
Street Address |
2627 RIVERSIDE AVE |
City | JACKSONVILLE |
State | FL |
Zip Code | 32204-4717 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770575052 | Belton Craig Ray | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4712 | 2005-08-22 |
1215549316 | Renee E Alten | Student in an Organized Health Care Education/Training Program | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-08-19 |
1114538634 | Faradia Pierre | Student in an Organized Health Care Education/Training Program | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-08-10 |
1841817772 | Kelsey Rhae Williams | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
1477170488 | Lisa Michelle Alley | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
1104443126 | Verniecea J Harris | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
1508483421 | Lacey J Rokita | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
1497372320 | Annika Tabassum | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
1023635943 | Yvonne Nyakio Kamau | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
1235754979 | Jenna Marie Driscoll | Student in an Organized Health Care Education/Training Program | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-09 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
Find all providers in zip 32204 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548860711 | Lee Thomas Hagenbaumer | Student in an Organized Health Care Education/Training Program | 10100 Baymeadows Rd Apt 802, Jacksonville, FL 32256-7196 | 2020-10-27 |
1508463456 | Juana Maria Hodac | Student in an Organized Health Care Education/Training Program | 8680 Baymeadows Rd E Apt 1018, Jacksonville, FL 32256-3994 | 2020-10-05 |
1366053043 | Amanda Brunner | Student in an Organized Health Care Education/Training Program | 404 Henry Rd Sw, Jacksonville, AL 36265-3338 | 2020-08-14 |
1528679206 | Deandrea Joice Stowe | Student in an Organized Health Care Education/Training Program | 519 Ladiga St Se, Jacksonville, AL 36265-2691 | 2020-08-14 |
1558970558 | Imran Ahmed Mridha | Student in an Organized Health Care Education/Training Program | 7932 Southside Blvd Apt 2409, Jacksonville, FL 32256-7958 | 2020-07-24 |
1750908588 | Irissel Rodriguez | Student in an Organized Health Care Education/Training Program | 2800 University Blvd S Apt 282, Jacksonville, FL 32216-2587 | 2020-06-27 |
1629692413 | Diana Piotrowski | Student in an Organized Health Care Education/Training Program | 100 Magnolia St Apt 6105, Jacksonville, FL 32204-2256 | 2020-06-08 |
1922622778 | Ryan D'armond Navarre | Student in an Organized Health Care Education/Training Program | 100 Magnolia St Apt 6213, Jacksonville, FL 32204-2257 | 2020-06-07 |
1063036937 | Karen Rebecca Clement | Student in an Organized Health Care Education/Training Program | 4929 Skyway Dr Apt 5212, Jacksonville, FL 32246-0047 | 2020-06-05 |
1134743107 | Christine Lalime | Student in an Organized Health Care Education/Training Program | 220 Riverside Ave Unit 203, Jacksonville, FL 32202-4947 | 2020-06-04 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 32204 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.