Organization Active NPI

Jax Healthcare LLC

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1174356554
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
JAX HEALTHCARE LLC
Practice address
11512 Lake Mead Ave Unit 702
Jacksonville, FL 32256-9681
Phone
(904) 586-2527
NPI assigned
Aug 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Authorized official

Name
Yuriel Gonzalez Exposito
Title
Owner
Phone
(305) 494-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

11512 Lake Mead Ave Unit 702
Jacksonville, FL 32256-9681

Mailing address

2222 Walkers Glen LN
Jacksonville, FL 32246-7176

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2325967Jax Healthcare LLC11512 Lake Mead Ave, Unit 703, Jacksonville, FL 32256Certificate of waiverJun 23, 2027

National Provider Directory

National Provider Directory

Locations

11512 Lake Mead Ave
Unit 702
Jacksonville, FL 32256
Phone (904) 586-2527

NPI Registry JSON

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1174356554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 WALKERS GLEN LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11512 LAKE MEAD AVE UNIT 702",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569681",
            "telephone_number": "904-586-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAX HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-21",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ EXPOSITO",
        "authorized_official_first_name": "YURIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-494-1100"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "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 May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.