Organization
DREAM PRIMARY CARE LLC
Active
Other names
Dream Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANNA MILES (CREDENTIALING SPECIALIST)
(904) 868-8923
Entity
Organization
Contact information
Practice address
2255 DUNN AVE STE 503, JACKSONVILLE, FL 32218-4742
(904) 521-7564
Mailing address
2255 DUNN AVE STE 503, JACKSONVILLE, FL 32218-4742
(904) 521-7564
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
04/23/2025
Last updated
04/30/2025
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