Individual
CONSUELO TOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4190 BELFORT RD STE 140, JACKSONVILLE, FL 32216-5871
(904) 296-2999
Mailing address
13453 N MAIN ST STE 104, JACKSONVILLE, FL 32218-2773
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11033619
FL
Other
Enumeration date
06/26/2024
Last updated
12/14/2024
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