Individual
MARVINA SCRUGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
379 E 47TH ST, JACKSONVILLE, FL 32208-5463
(904) 726-7970
Mailing address
379 E 47TH ST, JACKSONVILLE, FL 32208-5463
(904) 726-7970
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
372600000X
Adult Companion
235397
FL
374U00000X
Home Health Aide
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81-1835965
IRS
FL
Enumeration date
10/30/2018
Last updated
12/27/2018
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