Individual
LAURA R DIMMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
820 PRUDENTIAL DR STE 713, JACKSONVILLE, FL 32207-8209
(904) 396-5682
(904) 346-0864
Mailing address
8649 AUTUMN GREEN DR, JACKSONVILLE, FL 32256-9560
(904) 476-6438
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME73498
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000786871D
—
GA
05
—
254874700
—
FL
01
—
44334
BCBS OF FLORIDA
FL
01
—
P00138982
RAILROAD MEDICARE
FL
01
—
P00395758
RAILROAD MEDICARE
—
Enumeration date
07/20/2006
Last updated
11/03/2025
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