Organization
ST. JOHNS RIVER RURAL HEALTH NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI ANN BILELLO (ADMINISTRATOR)
(904) 723-2162
Entity
Organization
Contact information
Practice address
644 CESERY BLVD, SUITE 210, JACKSONVILLE, FL 32211-7116
(904) 723-2162
(904) 723-2170
Mailing address
644 CESERY BLVD, SUITE 210, JACKSONVILLE, FL 32211-7165
(904) 723-2162
(904) 723-2170
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
914321100
—
FL
Enumeration date
02/27/2007
Last updated
04/30/2008
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