OrganizationActive
Kpncinc
NPI 1629414479 · Nursing Facility/Intermediate Care Facility · Jacksonville, FL
Provider details
- NPI number
- 1629414479
- Entity type
- Organization
- Primary specialty
- Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Agelet St Hubert, Owner/President(904) 554-6051
- License
- 6906603 (FL)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
764 Aqua Surf Ct
Jacksonville, FL 32225-0802
Phone: (904) 554-6051
Fax: (904) 361-3235
Approximate (ZIP-level) locationGet directions
Mailing address
764 Aqua Surf Ct
Jacksonville, FL 32225-0802
Registry dates
- Enumerated
- 2013-05-21
- Last updated
- 2013-05-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.