Individual provider Active NPI

Madeline Elise Jubran, PHD

  • Student in an Organized Health Care Education/Training Program
  • Jacksonville, FL
National Provider Identifier
1265348650
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
12443 San Jose Blvd Ste 204
Jacksonville, FL 32223-8648
Phone
(904) 432-3321
NPI assigned
Aug 24, 2026
Last updated
Aug 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

12443 San Jose Blvd Ste 204
Jacksonville, FL 32223-8648

Mailing address

3638 Holly Grove Ave
Jacksonville, FL 32217-4234
Phone (904) 304-3415

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": "1787529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1265348650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3638 HOLLY GROVE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174234",
            "telephone_number": "904-304-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12443 SAN JOSE BLVD STE 204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238648",
            "telephone_number": "904-432-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUBRAN",
        "first_name": "MADELINE",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-24",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "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 Aug 24, 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.