Organization
5JAGHEALTH, PLLC
Active
Other names
Suwannee Oaks Medical Primary and Wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AYMEE WILSON APRN (OWNER)
(386) 330-6380
Entity
Organization
Contact information
Practice address
112 IRVIN AVE SW, LIVE OAK, FL 32064-2214
(386) 647-6144
Mailing address
8405 127TH DR, LIVE OAK, FL 32060-8835
(386) 647-6144
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/04/2023
Last updated
02/08/2024
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