Individual
RANA ALISSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
820 PRUDENTIAL DR, HOWARD BLDG, SUITE 614, JACKSONVILLE, FL 32207-8210
(904) 202-4212
(904) 202-4219
Mailing address
820 PRUDENTIAL DR, HOWARD BLDG, SUITE 614, JACKSONVILLE, FL 32207-8210
(904) 202-4212
(904) 202-4219
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME116456
FL
208000000X
Pediatrics Physician
TRN14670
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003137176A
—
GA
05
—
009409900
—
FL
01
—
14RF1
BCBS
FL
Enumeration date
05/06/2010
Last updated
12/05/2013
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