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Individual

LISA AWE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 202-8758
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 202-8758

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME149554
FL

Other

Enumeration date
03/26/2017
Last updated
06/06/2023
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