Provider Demographics
NPI:1104628130
Name:DINGLE, JASMIN
Entity type:Individual
Prefix:
First Name:JASMIN
Middle Name:
Last Name:DINGLE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1164 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32206-3215
Mailing Address - Country:US
Mailing Address - Phone:904-844-6411
Mailing Address - Fax:
Practice Address - Street 1:1164 E 17TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206-3215
Practice Address - Country:US
Practice Address - Phone:904-844-6411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health