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Organization
FOCUSED WELLNESS CLINIC LLC
Active
Organization
FOCUSED WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONSTANCE R HARGROVE APRN (AUTHORIZED MEMBER)
(904) 872-4245
Entity
Organization
Contact information
Practice address
767 BLANDING BLVD STE 105, ORANGE PARK, FL 32065-5788
(904) 872-4245
(904) 877-3453
Mailing address
767 BLANDING BLVD STE 105, ORANGE PARK, FL 32065-5788
(904) 872-4245
(904) 877-3453
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/27/2021
Last updated
11/05/2025
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