Individual
KAYLA BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11945 SAN JOSE BLVD, JACKSONVILLE, FL 32223-1613
(904) 262-5333
Mailing address
11945 SAN JOSE BLVD, JACKSONVILLE, FL 32223-1613
(904) 262-5333
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
1023579992
FL
207V00000X
Obstetrics & Gynecology Physician
Primary
162816
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2019
Last updated
07/11/2023
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