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Individual

DR. RAQUEL SKIDMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
219 FOREST PARK CIR, PANAMA CITY, FL 32405-4920
(850) 215-9418
(850) 215-9419
Mailing address
219 FOREST PARK CIRCLE, PANAMA CITY, FL 32405
(850) 215-9418
(850) 215-9419

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
14439
PR
207K00000X
Allergy & Immunology Physician
ACN244
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006732100
FL
01
12542810
CAQH ID
01
14439
LICENCIA
PR
01
ACN244
FL PHYSICIAN LICENSE
FL
Enumeration date
10/07/2005
Last updated
11/30/2016
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