Individual
MS. SUSHMA K VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6207 BENNETT RD, JACKSONVILLE, FL 32216-5007
(904) 241-7865
Mailing address
6207 BENNETT RD, JACKSONVILLE, FL 32216-5007
(941) 241-7865
(407) 470-1043
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME122617
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014425300
—
FL
01
—
ME122617
LISCENCE
FL
Enumeration date
08/13/2007
Last updated
03/28/2024
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