Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Impact 13 Medical, PLLC

Organization Clinical Social Worker · NPI 1548805617

Impact 13 Medical, PLLC is a Clinical Social Worker in Jacksonville, Florida. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
5
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10752 Deerwood Park Blvd South Waterview Ii Ste 100
Jacksonville, FL 32256
Phone: (904) 755-1017
Fax: (646) 774-0386
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X
Clinical Social Worker Taxonomy 1041C0700X
Child & Adolescent Psychiatry Physician Taxonomy 2084P0804X
Geriatric Psychiatry Physician Taxonomy 2084P0805X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1548805617
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wil Germain — Owner · (516) 412-1608
NPI enumeratedNovember 13, 2019
Last updated in NPPESDecember 18, 2019
Certification dateDecember 18, 2019
Mailing address10752 Deerwood Park Blvd, South Waterview Ii Suite 100, Jacksonville, FL 32256-8666

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