Active NPI
Donald Maestre
- Developmental Disabilities Clinic/Center
- Jacksonville, FL
National Provider Identifier
1124715719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Disabilities Clinic/Center
- Practice address
- 9939 Byrnes Rd Unit 2
Jacksonville, FL 32246-8632 - Phone
- (904) 422-8414
- NPI assigned
- Apr 24, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Developmental Disabilities Clinic/Center | 261QD1600X | Primary |
Addresses
Primary practice location
9939 Byrnes Rd Unit 2
Jacksonville, FL 32246-8632
Mailing address
3836 Evan Samuel Dr
Jacksonville, FL 32210-0404
Phone (904) 422-8414
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682294400000",
"number": "1124715719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3836 EVAN SAMUEL DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322100404",
"telephone_number": "904-422-8414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9939 BYRNES RD UNIT 2",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322468632",
"telephone_number": "904-422-8414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAESTRE",
"first_name": "DONALD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-24",
"last_updated": "2023-04-24",
"certification_date": "2023-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "261QD1600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.