FRESH HEADS LICE REMOVAL (NPI# 1548790298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548790298 |
| Entity Type | Organization |
| Organization Name | FRESH HEADS LICE REMOVAL |
| Practice Address |
13241 Bartram Park Blvd Unit 1801 Jacksonville FL 32258-5227 |
| Mailing Address |
653 Lake Stone Cir Ponte Vedra Beach FL 32082-4342 |
| Practice Telephone | 9045174087 |
| Mailing Telephone | 9042353157 |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2017-06-15 |
| Authorized Official Name | MR. DWIGHT L OTTESEN (OWNER) |
| Authorized Official Telephone | 9046864175 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247200000X | Technician, Other | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
13241 BARTRAM PARK BLVD UNIT 1801 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32258-5227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437794237 | Nicoleta Descalzo | Behavior Technician | 12724 Grand Bay Parkway West, Suite 410, Jacksonville, FL 32258 | 2019-11-15 |
| 1992275572 | William Lundgren | Nurse Anesthetist, Certified Registered | 3625 University Blvd South, Jacksonville, FL 32258 | 2018-11-27 |
| 1104301159 | Emergency Physicians Inc | Emergency Medicine | 14534 Old St Augustine Rd, Suite 3110, Jacksonville, FL 32258 | 2018-09-26 |
| 1679092886 | Palm Life Medical Associates Pa | Assisted Living Facility | 12494 Acosta Oaks Drive, Jacksonville, FL 32258 | 2017-09-19 |
| 1679013932 | Optometry Vision Care Pllc | Optometrist | 14866 Old St. Augustine Rd Unit 110, Jacksonville, FL 32258 | 2017-03-06 |
| 1467991950 | North Florida Vision Group Inc | Optometrist | 14866 Old St. Augustine Rd., Suite 110, Jacksonville, FL 32258 | 2017-02-16 |
| 1124576566 | Revolution Chiropractic LLC | Chiropractor | 14866 Old St Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-14 |
| 1396291936 | Robyn Reaves | Nurse Practitioner | 12361 Richards Glen Ct, Jacksonville, FL 32258 | 2016-09-01 |
| 1326595927 | Lauren Cost | Chiropractor | 14866 Old St. Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-01 |
| 1487991170 | Mark Steven Colosimo | Pharmacist | 13820 Old St Augustine Road, Jacksonville, FL 32258 | 2013-01-15 |
| Find all providers in zip 32258 | ||||
| Taxonomy Code | 247200000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Technician, Other |
| A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |
| Notes: Sources: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988; Dorland’s Illustrated Medical Dictionary, 26th Edition. Philadelphia: W.B. Saunders Company, 1981; and Webster’s II New Riverside University Dictionary. Boston: Riverside Publishing Company, 1984. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255819009 | Shavon Chanta Burney | Technician, Other | 12337 Wynnfield Lakes Dr Unit 1721, Jacksonville, FL 32246-4272 | 2018-08-03 |
| 1548747751 | Analiese Marie Fazio | Technician, Other | 5900 Townsend Rd Apt 815, Jacksonville, FL 32244-4579 | 2018-07-20 |
| 1619489994 | Tracey Moraine Lewis | Technician, Other | 1060 Ontario St, Jacksonville, FL 32254-2040 | 2017-10-26 |
| 1538695754 | Shilonda Peterson-jackson | Technician, Other | 3437 Miruelo Cr N, Jacksonville, FL 32217 | 2017-05-08 |
| 1881146074 | Arthur Hairston | Technician, Other | 5633 Clifton Lane, Jacksonville, FL 32211 | 2016-11-04 |
| 1528519717 | Patricia Coleman | Technician, Other | 3820 Losco Rd Apt 216, Jacksonville, FL 32257-1420 | 2016-10-22 |
| 1669920278 | Denise Miller | Technician, Other | 7033 Swamp Flower Dr N, Jacksonville, FL 32244-6155 | 2016-09-13 |
| 1891241832 | Danitha Blanchard | Technician, Other | 15879 Tisons Bluff Rd, Jacksonville, FL 32218-0125 | 2016-08-30 |
| 1881040103 | Stacey Renee Ludban | Technician, Other | 3726 Longleaf Forest Ln, Jacksonville, FL 32210-6896 | 2016-05-05 |
| 1023471984 | Courtney Hermsdorfer | Technician, Other | 9536 Princeton Square Blvd S, Apt 1512, Jacksonville, FL 32256-0322 | 2016-03-29 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32258 |
Please comment or provide details below to improve the information on FRESH HEADS LICE REMOVAL.
| 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.