Individual
KEVIN R. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.R.N.P.
Contact information
Practice address
1824 KING ST STE 300, JACKSONVILLE, FL 32204
(904) 388-1820
(904) 388-1827
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 296-5691
(904) 450-6401
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP2869582
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012160200
—
FL
Enumeration date
05/19/2006
Last updated
08/09/2018
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