Individual
EMILIYA MUSTAFAEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5464 ROLLINS AVE, JACKSONVILLE, FL 32207-7715
(904) 888-7629
Mailing address
5464 ROLLINS AVE, JACKSONVILLE, FL 32207-7715
(904) 888-7629
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
236502
FL
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106052200
—
FL
Enumeration date
03/13/2020
Last updated
02/26/2021
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