Individual
DEVANSHI MODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
841 PRUDENTIAL DR, 10TH FLOOR, JACKSONVILLE, FL 32207-8329
(904) 398-5404
(904) 391-5595
Mailing address
PO BOX 41113, JACKSONVILLE, FL 32203-1113
(904) 376-4400
(904) 391-5595
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME120949
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015696800
—
FL
01
—
P01574199
RAILROAD MEDICARE
FL
Enumeration date
06/28/2010
Last updated
03/11/2016
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