Individual
THOMASINA JACINTA FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5913 FLORADALE DR, JACKSONVILLE, FL 32209-2300
(904) 387-4661
Mailing address
5913 FLORADALE DR, JACKSONVILLE, FL 32209-2300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2514152
FL
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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