Individual
BLONDEVA BETHEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PEER SPECIALIST
Contact information
Practice address
555 STOCKTON ST, JACKSONVILLE, FL 32204-2534
(904) 387-4667
Mailing address
555 STOCKTON ST, JACKSONVILLE, FL 32204-2534
(904) 387-4667
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0100096
FL
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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