Provider Demographics
NPI:1548148059
Name:DRIVER SIGNATURE HEALTH LLC
Entity type:Organization
Organization Name:DRIVER SIGNATURE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:DRIVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-856-4041
Mailing Address - Street 1:5011 GATE PARKWAY
Mailing Address - Street 2:BUILDING 100 SUITE 100
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:479-856-4041
Mailing Address - Fax:
Practice Address - Street 1:5011 GATE PARKWAY
Practice Address - Street 2:BUILDING 100 SUITE 100
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256
Practice Address - Country:US
Practice Address - Phone:479-856-4041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty