Organization
SOUTHBRDGE HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORA AGYEI AGYEMANG MSN, APRN, ANP-BC (OWNER)
(912) 800-9220
Entity
Organization
Contact information
Practice address
476 RIVERSIDE AVE # 1905, JACKSONVILLE, FL 32202-4912
(904) 800-9220
(904) 674-1843
Mailing address
851 SOUTHBRIDGE BLVD, SAVANNAH, GA 31405-1096
(912) 657-5256
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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