Individual
NICOLE MING MING LOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
ME150435
FL
207RG0100X
Gastroenterology Physician
Q9419
TX
207RI0008X
Hepatology Physician
Q9419
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
364366001
—
TX
Enumeration date
07/17/2009
Last updated
05/25/2021
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