Individual
STEPHANIE AGELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
820 PRUDENTIAL DR STE 713, JACKSONVILLE, FL 32207
(904) 396-5682
Mailing address
820 PRUDENTIAL DR STE 713, JACKSONVILLE, FL 32207-8209
(904) 396-5682
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME135679
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2015
Last updated
06/08/2018
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