Individual
CASSAUNDRA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4205 BELFORT RD STE 3075, JACKSONVILLE, FL 32216-1475
(904) 296-5785
(904) 296-4786
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6017
(904) 450-6041
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS16518
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106227500
—
FL
Enumeration date
03/09/2017
Last updated
09/28/2020
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