Individual
MRS. SOPHIA FORSYTH SCULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204-4748
(904) 308-7300
Mailing address
2304 LATRIUM CIR N, PONTE VEDRA, FL 32082-2920
(904) 874-9091
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
AA658
FL
Other
Enumeration date
08/29/2021
Last updated
03/20/2023
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