Islimlipo

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ISLIMLIPO

Practice address

4540 Southside Blvd Ste 401
Jacksonville, FL 32216-5488

Phone

(772) 281-7682

NPI assigned

Aug 28, 2020

Organization subpart

No

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

Authorized official

Name

Allison Kern

Title

Director of Operations

Phone

(772) 281-7682

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600387200000",
    "number": "1801409909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 SOUTHSIDE BLVD STE 401",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165488",
            "telephone_number": "772-281-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 SOUTHSIDE BLVD STE 401",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165488",
            "telephone_number": "772-281-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLIMLIPO",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A",
        "authorized_official_last_name": "KERN",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "772-281-7682"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "endpointDescription": "Jacksonville",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4540 Southside Blvd Ste 401",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322165488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Isabel Chavely Isla Venzant
• Alen Islamovic
• Amber Lynn Isley, M.D.
• Islf Deerwood Place Jacksonville, LLC
• Islf-Deerwood Place-Jacksonville LLC
• Shahin Hamid Ismail, SAA
• Joel Isom, RN
• Ronnie Israel, DMD
• Sa'Dieya Mahlah Israel
• Shavonna Jewdeyah Israel

• Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.