Second Chance LLC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

SECOND CHANCE LLC

Practice address

5494 Logan Cave Ave
Wimauma, FL 33598-2440

Phone

(727) 265-0224

NPI assigned

May 26, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William Jackson

Title

Owner

Phone

(727) 265-0224

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1779753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779753600000",
    "number": "1013848209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35225",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337050504",
            "telephone_number": "727-265-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5494 LOGAN CAVE AVE",
            "city": "WIMAUMA",
            "state": "FL",
            "postal_code": "335982440",
            "telephone_number": "727-265-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-26",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-265-0224"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Worker in Wimauma, FL
• Providers in Wimauma, FL by specialty
• Community Health Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.