Individual
DR. JENNIFER CARROLL FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1325 SAN MARCO BLVD STE 300, JACKSONVILLE, FL 32207-8567
(904) 253-6910
(904) 253-6964
Mailing address
1325 SAN MARCO BLVD STE 300, JACKSONVILLE, FL 32207-8567
(904) 253-6910
(904) 253-6964
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME104269
FL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME104269
FL
207RP1001X
Pulmonary Disease Physician
ME 104269
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME104269
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004352900
—
FL
Enumeration date
11/07/2006
Last updated
10/26/2022
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