J 4 Dynasty, LLC

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

Legal business name

J 4 DYNASTY, LLC

Practice address

10150 Highland Manor Dr Ste 200-106
Tampa, FL 33610-9713

Phone

(813) 606-5010

Fax

(877) 228-8577

NPI assigned

Jul 5, 2021

Organization subpart

No

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

Authorized official

Name

Latoria Clark-Jackson, LPNNPI 1538787353

Title

Owner/MGR

Phone

(813) 606-5010

Specialties & licenses 6

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Latoria Clark-Jackson, LPN

  • Licensed Practical Nurse
  • Gibsonton, FL
  • NPI 1538787353
  NPD Authorized official

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

{
    "created_epoch": "1625443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625443200000",
    "number": "1760053441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10150 HIGHLAND MANOR DR STE 200-106",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336109713",
            "telephone_number": "813-606-5010",
            "fax_number": "877-228-8577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 HIGHLAND MANOR DR STE 200-106",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336109713",
            "telephone_number": "813-606-5010",
            "fax_number": "877-228-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J 4 DYNASTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-05",
        "last_updated": "2021-07-05",
        "certification_date": "2021-07-02",
        "status": "A",
        "authorized_official_last_name": "CLARK-JACKSON",
        "authorized_official_first_name": "LATORIA",
        "authorized_official_title_or_position": "OWNER/MGR",
        "authorized_official_telephone_number": "813-606-5010",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Isabel Izquierdo
• Nadia Maria Izquierdo
• Izzo & Alkire MD PA
• Giulia Sonego Izzo Castellano, DO
• J & J Rehab Medical Center Inc
• J W Rodriguez MD
• J. Paonessa M.D. P.a.
• J. Paonessa M.D.P.a.
• J. Russell Lowrey, D.P.M., P.L.C.
• J.a Santiago, Ms, RPT, P.a

• Licensed Practical Nurse in Tampa, FL
• Providers in Tampa, FL by specialty
• Licensed Practical Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.