| Diabetico Internacional, Inc. | |
|
2520 University Blvd W Jacksonville FL 32217-2004 | |
| (904) 914-8947 | |
| (904) 895-4729 |
| Full Name | Diabetico Internacional, Inc. |
|---|---|
| Speciality | Registered Nurse |
| Location | 2520 University Blvd W, Jacksonville, Florida |
| Authorized Official Name and Position | Lavern Webster-dowell (PRESIDENT/CEO) |
| Authorized Official Contact | 9042537967 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diabetico Internacional, Inc. 2520 University Blvd W Jacksonville FL 32217-2004 Ph: (904) 914-8947 | Diabetico Internacional, Inc. 2520 University Blvd W Jacksonville FL 32217-2004 Ph: (904) 914-8947 |
| NPI Number | 1245554799 |
|---|---|
| Provider Enumeration Date | 03/25/2010 |
| Last Update Date | 10/14/2024 |
| Medicare PECOS PAC ID | 7315133949 |
|---|---|
| Medicare Enrollment ID | O20101122001133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245554799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 163WD0400X | Registered Nurse - Diabetes Educator | 3300612 (Florida) | Primary |
| Provider Name | Laverne Dowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306222419 PECOS PAC ID: 7618165952 Enrollment ID: I20151001001345 |
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