| Wildflowers & Weeds | |
|
4110 Southpoint Blvd Ste 116 Jacksonville FL 32216-0925 | |
| (904) 325-9155 | |
| Not Available |
| Full Name | Wildflowers & Weeds |
|---|---|
| Speciality | Social Worker |
| Location | 4110 Southpoint Blvd Ste 116, Jacksonville, Florida |
| Authorized Official Name and Position | Amanda Forrest (OWNER) |
| Authorized Official Contact | 9043259155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wildflowers & Weeds 13245 Atlantic Blvd Ste 4-243 Jacksonville FL 32225-7121 Ph: () - | Wildflowers & Weeds 4110 Southpoint Blvd Ste 116 Jacksonville FL 32216-0925 Ph: (904) 325-9155 |
| NPI Number | 1508437773 |
|---|---|
| Provider Enumeration Date | 07/08/2021 |
| Last Update Date | 04/12/2022 |
| Certification Date | 04/12/2022 |
| Medicare PECOS PAC ID | 6507261401 |
|---|---|
| Medicare Enrollment ID | O20210816001443 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508437773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amanda Forrest |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346575057 PECOS PAC ID: 0345594768 Enrollment ID: I20181120003156 |
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