Organization
FULTON GIBBS WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH G BAGAN APRN (PRESIDENT)
(904) 454-4937
Entity
Organization
Contact information
Practice address
8825 PERIMETER PARK BLVD STE 102, JACKSONVILLE, FL 32216-1127
(904) 454-4937
(904) 293-1325
Mailing address
731 DUVAL STATION RD STE 107-204, JACKSONVILLE, FL 32218-0800
(904) 454-4937
(904) 293-1325
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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