Individual
DAVID MAYNOLDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1202 KINGSLEY AVE, ORANGE PARK, FL 32073-4632
(877) 842-4020
(877) 842-4020
Mailing address
5000-18 US HIGHWAY 17 SOUTH, 241, FLEMING ISLAND, FL 32003
(877) 842-4020
(877) 842-4020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME130811
FL
208M00000X
Hospitalist Physician
Primary
ME130811
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163944
ABFM
FL
01
—
73904
MEDICAL LICENSE
GA
01
—
ME130811
FLORIDA MEDICAL LICENSE
FL
Enumeration date
01/20/2012
Last updated
03/23/2018
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