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Individual

MRS. DONNA ROBIN POTTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4712
(904) 308-7372
(904) 308-2998
Mailing address
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4712
(904) 308-7372
(904) 308-2998

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0066571
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080121854
MEDICARE RAILROAD
FL
01
19310
HEALTHEASE
FL
01
27149
BCBS
FL
01
3521981-001
CIGNA
FL
05
378388000
FL
01
5957032
AETNA
FL
Enumeration date
08/22/2005
Last updated
07/13/2009
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