Lillys Medical Center LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

LILLYS MEDICAL CENTER LLC

Practice address

4241 Baymeadows Rd Ste 6
Jacksonville, FL 32217-4673

Phone

(407) 719-5723

NPI assigned

Mar 4, 2021

Last updated

Mar 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Georgette L Provost-Dukes, ARNPNPI 1689178667

Title

Arnp

Phone

(407) 719-5723

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Georgette Louise Provost-Dukes, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1689178667

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1063007854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 BAYMEADOWS RD STE 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174673",
            "telephone_number": "407-719-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 BAYMEADOWS RD STE 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174673",
            "telephone_number": "407-719-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILLYS MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "PROVOST-DUKES",
        "authorized_official_first_name": "GEORGETTE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ARNP",
        "authorized_official_telephone_number": "407-719-5723",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph T Lillia
• Lilliam Rivera
• Angel Lilly, APRN
• Lauren A Lilly, DDS
• Lillyes Heart (LeAndra E. Stafford)
• Alan Saruca Lim, MD
• Alexander S Lim, M.D.
• Andrew Lim, M.D.
• Chea Huei Lim, ARNP
• Hae Soo Lim, MD

• Primary Care Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.