Individual
MS. GAYNELL L LIVINGSTON-HODGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MEDICAID PROVIDER
Contact information
Practice address
1320 BROAD ST, SUITE # 202, JACKSONVILLE, FL 32202-3902
(904) 358-9487
Mailing address
1320 BROAD STN, SUITE # 202, JACKSONVILLE, FL 32202
(904) 358-9487
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
6933335-96
FL
Other
Enumeration date
07/23/2008
Last updated
07/23/2008
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