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Individual

DR. MICHELLE MCLANAHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
8075 GATE PARKWAY WEST, STE 305, JACKSONVILLE, FL 32216
(904) 296-2992
(904) 296-2993
Mailing address
8075 GATE PARKWAY WEST, STE 305, JACKSONVILLE, FL 32216-3685
(904) 296-2992
(904) 296-2993

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME69467
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
379135100
FL
Enumeration date
11/03/2005
Last updated
03/21/2012
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