Individual
MAHOGONY SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4455 ISH BRANT RD W, JACKSONVILLE, FL 32210-7046
(904) 566-4729
Mailing address
4455 ISH BRANT RD W, JACKSONVILLE, FL 32210-7046
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100246600
—
FL
Enumeration date
02/03/2022
Last updated
02/03/2022
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