Individual
DR. ANNEMARIE ETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
350 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2733
(386) 676-7103
(386) 676-7186
Mailing address
PO BOX 9671, DAYTONA BEACH, FL 32120-9671
(386) 676-7130
(386) 676-7125
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME86041
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013980655
TRICARE
FL
01
—
13215
BCBS
FL
05
—
272646700
—
FL
01
—
7237323
AETNA
FL
01
—
9032053
CIGNA
FL
01
—
P00230246
RAILROAD
FL
Enumeration date
02/13/2006
Last updated
02/22/2016
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