Individual
KAYELA FAYE BORISADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
13500 SUTTON PARK DRIVE SOUTH, SUITE 403, JACKSONVILLE, FL 32224-5291
(904) 493-3390
(904) 493-3395
Mailing address
13500 SUTTON PARK DRIVE SOUTH, SUITE 403, JACKSONVILLE, FL 32224-5291
(904) 493-3390
(904) 493-3395
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9233632
FL
363LF0000X
Family Nurse Practitioner
ARNP9233632
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45681
MEDICARE - GROUP
FL
01
—
9233632
FL ARNP LICENSE
FL
01
—
HL342Z
MEDICARE - INDIVIDUAL
FL
Enumeration date
11/15/2012
Last updated
06/06/2024
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