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Organization
XIII MOONS APOTHECARY & FUNCTIONAL WELLNESS CENTER
Active
Organization
XIII MOONS APOTHECARY & FUNCTIONAL WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KENYA BONNER (FOUNDER & CEO)
(904) 551-0110
Entity
Organization
Contact information
Practice address
6050 MONCRIEF RD STE 8, JACKSONVILLE, FL 32209-2564
(904) 551-0110
Mailing address
6050 MONCRIEF RD STE 8, JACKSONVILLE, FL 32209-2564
(904) 551-0110
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
NULL
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
07/14/2026
Last updated
07/22/2026
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