Individual
MARK LATHROP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2449 BLACKBEARD DR, JACKSONVILLE, FL 32224-1139
(904) 238-0070
Mailing address
2449 BLACKBEARD DR, JACKSONVILLE, FL 32224-1139
(904) 238-0070
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9415770
FL
363L00000X
Nurse Practitioner
APRN11032408
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
148709
FL
Other
Enumeration date
08/04/2023
Last updated
02/11/2025
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