Individual
DR. PHYLLIS LILLIAN HENDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, UFJP EMERGENCY MEDICINE, JACKSONVILLE, FL 32209-6511
(904) 244-4124
(904) 244-3432
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME54625
FL
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
ME54625
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000469829A
—
GA
05
—
0549053-00
—
FL
Enumeration date
01/28/2006
Last updated
07/23/2008
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