Individual
MR. WILSON JATIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 697-3461
Mailing address
9270 HAWKS POINT DR, JACKSONVILLE, FL 32222-2831
(904) 697-3461
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9232271
FL
Other
Enumeration date
03/18/2009
Last updated
03/18/2009
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