Individual
JIN HEE RA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
655 W 8TH ST, UFJP SURGERY DEPARTMENT, JACKSONVILLE, FL 32209-6511
(904) 383-1015
(904) 244-4079
Mailing address
PO BOX 44008, UFJP SURGERY DEPARTMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MT179830
PA
2086S0102X
Surgical Critical Care Physician
Primary
ME107640
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0024329-00
—
FL
05
—
581826893A
—
GA
Enumeration date
01/04/2007
Last updated
01/10/2011
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