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Individual

KAYLA MARIE DEMUS WILMOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1215 DUNN AVE STE 1, JACKSONVILLE, FL 32218-4897
(904) 745-3618
Mailing address
6520 FORT CAROLINE RD, JACKSONVILLE, FL 32277-2044
(904) 745-3618
(904) 722-4271

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
9113901
FL
363AM0700X
Medical Physician Assistant
Primary
PA9113901
FL
363LF0000X
Family Nurse Practitioner
PA9113901
FL

Other

Enumeration date
08/19/2020
Last updated
06/25/2021
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