Organization
CARLSON MEDICAL, PLLC
Active
Other names
Wise Women
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INGRID A CARLSON MD (PRESIDENT)
(904) 395-3577
Entity
Organization
Contact information
Practice address
486 TOWN PLAZA AVE, SUITE 440, PONTE VEDRA, FL 32081-5141
(904) 395-3577
(904) 834-7821
Mailing address
486 TOWN PLAZA AVE, SUITE 440, PONTE VEDRA, FL 32081-5141
(904) 395-3577
(904) 834-7821
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ME112115
FL
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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