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Individual

BARBARA LEIGH CRUIKSHANK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2300 PARK AVE STE 200, ORANGE PARK, FL 32073-5571
(904) 269-2900
(904) 269-1140
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0052191
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05937
BCBS
FL
01
320007628
HUMANA
FL
01
4618068
AETNA
FL
Enumeration date
01/18/2007
Last updated
11/22/2019
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