Organization
ISLIMLIPO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON KERN (DIRECTOR OF OPERATIONS)
(772) 281-7682
Entity
Organization
Contact information
Practice address
4540 SOUTHSIDE BLVD STE 401, JACKSONVILLE, FL 32216-5488
(772) 281-7682
Mailing address
4540 SOUTHSIDE BLVD STE 401, JACKSONVILLE, FL 32216-5488
(772) 281-7682
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
09/18/2020
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