Individual
MARY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1297 DUNNS LAKE DR, JACKSONVILLE, FL 32218-8098
(904) 430-2076
Mailing address
1297 DUNNS LAKE DR, JACKSONVILLE, FL 32218-8098
(904) 430-2076
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5206884
FL
Other
Enumeration date
05/07/2026
Last updated
05/07/2026
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