Individual
DR. JERI ANICE DYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, UFJP PEDIATRICS, JACKSONVILLE, FL 32209-6511
(904) 244-7260
(904) 244-4845
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME94306
FL
2080A0000X
Pediatric Adolescent Medicine Physician
ME94306
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2737558-00
—
FL
05
—
765179961A
—
GA
Enumeration date
03/12/2006
Last updated
04/01/2009
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