Active NPI
Shirley Lynn Fabrizio, ARNP
- Nurse Practitioner
- Jacksonville Beach, FL
National Provider Identifier
1093722647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 2212592
- Practice address
- 1375 Roberts Dr
Suite 103
Jacksonville Beach, FL 32250-3210 - Phone
- (904) 997-3800
- Fax
- (904) 997-3899
- NPI assigned
- Aug 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2212592 | FL | Primary |
Addresses
Primary practice location
1375 Roberts Dr
Suite 103
Jacksonville Beach, FL 32250-3210
Mailing address
7015 A C Skinner Pkwy
Suite 1
Jacksonville, FL 32256-6932
Phone (904) 363-2113
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3089061-00 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2212592 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462233600000",
"number": "1093722647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7015 A C SKINNER PKWY",
"address_2": "SUITE 1",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322566932",
"telephone_number": "904-363-2113",
"fax_number": "904-363-2606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1375 ROBERTS DR",
"address_2": "SUITE 103",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "322503210",
"telephone_number": "904-997-3800",
"fax_number": "904-997-3899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABRIZIO",
"first_name": "SHIRLEY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-02",
"last_updated": "2016-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "2212592",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3089061-00",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.