Individual
CAROLYN MASCHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1824 KING ST, JACKSONVILLE, FL 32204-4735
(904) 388-1820
(904) 388-1827
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6004
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704267111
MI
363L00000X
Nurse Practitioner
Primary
ARNP9421537
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016811800
—
FL
01
—
4704267111
MICHIGAN STATE LICENSE
MI
Enumeration date
12/17/2014
Last updated
11/09/2017
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