Organization Active NPI

Jacksonville Integrative Health LLC

  • General Practice Physician
  • Jacksonville, FL
National Provider Identifier
1861089062
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
JACKSONVILLE INTEGRATIVE HEALTH LLC
Practice address
13241 Bartram Park Blvd Unit 2501
Jacksonville, FL 32258-5218
Phone
(904) 299-6000
Fax
(904) 299-6001
NPI assigned
Dec 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Authorized official

Name
Gabriel BusquetsNPI 1073905782
Title
Owner
Phone
(904) 621-4222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

13241 Bartram Park Blvd Unit 2501
Jacksonville, FL 32258-5218

Mailing address

13241 Bartram Park Blvd Unit 2501
Jacksonville, FL 32258-5218
Phone (904) 621-4222

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632960000000",
    "number": "1861089062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 2501",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585218",
            "telephone_number": "904-621-4222",
            "fax_number": "904-299-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 2501",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585218",
            "telephone_number": "904-299-6000",
            "fax_number": "904-299-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE INTEGRATIVE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-22",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A",
        "authorized_official_last_name": "BUSQUETS",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-621-4222"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Sep 30, 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.