Individual
MARINA CAMPOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2264 DELLWOOD AVE, JACKSONVILLE, FL 32204-3102
(904) 384-3888
Mailing address
2264 DELLWOOD AVE, JACKSONVILLE, FL 32204-3102
(904) 384-3888
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6905793
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142300200
—
FL
Enumeration date
06/07/2008
Last updated
06/07/2008
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