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

Mrs. Tina Patrice Bristol

Individual provider Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1346994845

Mrs. Tina Patrice Bristol is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jacksonville, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2022
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4455 Ish Brant Rd W
Jacksonville, FL 32210-7046
Phone: (904) 377-6612
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) Taxonomy 320900000X · Licence 016780800 (FL)

Record details

NPI number1346994845
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 4, 2022
Last updated in NPPESFebruary 4, 2022
Certification dateFebruary 4, 2022

Other providers in Jacksonville