Individual
MS. ANNTOINETTE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7555 BEACH BLVD STE 200, JACKSONVILLE, FL 32216-3003
(904) 996-7587
(904) 996-7591
Mailing address
PO BOX 54521, JACKSONVILLE, FL 32245-4521
(904) 996-7587
(904) 996-7591
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230925
MEDICARE LICENSE
FL
05
—
693325496
—
FL
Enumeration date
07/08/2009
Last updated
07/09/2009
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