Massengill, Lolita Condino
Massengill, Lolita Condino is an sole proprietor health care provider with primary practice located at 6665 Banbury Road , Jacksonville FL 32211. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Massengill, Lolita Condino can be contacted via phone (904) 745-9333.Contact Information
Primary practice address
6665 Banbury Road
Jacksonville FL 32211
Phone: (904) 745-9333
Fax: (904) 743-0046
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | ARNP2007072 | Florida |
Profile Details
| NPI number | 1871581660 |
|---|---|
| LBN Legal business name | Massengill, Lolita Condino |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 6th, 2005 |
| Last updated | Mar 22nd, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871581660 | NPPES |
| Florida | MEDICAID | 300697200 |
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