Individual
AGELET ST.HUBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AFCH PROVIDER
Contact information
Practice address
764 AQUA SURF CT, JACKSONVILLE, FL 32225-0802
(904) 554-6051
Mailing address
764 AQUA SURF CT, JACKSONVILLE, FL 32225-0802
(904) 554-6051
(866) 373-1832
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906603
FL
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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