# NIRVANA CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Nirvana Wellness Solutions Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205923174
- **Authorized official:** MR. WILLE E ANDRE PA (PRESIDENT CEO)
- **Authorized official phone:** (904) 296-9090

## Contact information

- **Practice address:** 9550-9 BAYMEADOWS ROAD, JACKSONVILLE, FL 32256
- **Practice address phone:** (904) 739-7398
- **Practice address fax:** (904) 739-3888
- **Mailing address:** 6817 SOUTHPOINT PARKWAY SUITE 604, JACKSONVILLE, FL 32216
- **Mailing address phone:** (904) 296-9090
- **Mailing address fax:** (904) 296-9050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 08/22/2020