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Individual

MS. ILONA SUZANNE FENYO-MORALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1255 LILA ST, UFJP LEM TURNER FAMILY PRACTICE CENTER, JACKSONVILLE, FL 32208-3550
(904) 244-5700
(904) 244-5825
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1837
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100002429A
GA
05
2907097-00
FL
Enumeration date
03/23/2006
Last updated
11/24/2008
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