Individual
MRS. LETISHA RENEE BRAZILE JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2121 PARK ST, JACKSONVILLE, FL 32204-3811
(904) 387-6200
Mailing address
2121 PARK ST, JACKSONVILLE, FL 32204-3811
(904) 387-6200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME123225
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014578800
—
FL
Enumeration date
04/13/2011
Last updated
01/18/2018
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