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

Mary Peterson, ADMINISTRATOR

Individual provider Assisted Living Facility · NPI 1063221646

Mary Peterson, ADMINISTRATOR is an Assisted Living Facility in Jacksonville, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2025

Practice location Address checks out

1622 Silver St
Jacksonville, FL 32206-4446
Phone: (904) 356-3022
Fax: (904) 350-9165
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence 8638 (FL)

Record details

NPI number1063221646
Entity typeIndividual (Type 1)
GenderFemale
Credentials ADMINISTRATOR
Sole proprietorYes
NPI enumeratedJanuary 7, 2025
Last updated in NPPESJanuary 7, 2025
Certification dateJanuary 7, 2025

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