Individual
NAKISH DANIELLE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3625 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4207
(904) 702-6111
Mailing address
893 GLENNEYRE CIR, ST AUGUSTINE, FL 32092-1230
(708) 227-6253
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2008017890
MO
208D00000X
General Practice Physician
Primary
ME140616
FL
Other
Enumeration date
06/25/2008
Last updated
11/01/2023
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