Individual
ILICIA LAUREN SHUGARMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
700 3RD ST STE 302, NEPTUNE BEACH, FL 32266-5082
(904) 997-3800
(904) 997-3899
Mailing address
7015 A C SKINNER PKWY, SUITE 1, JACKSONVILLE, FL 32256-6932
(904) 363-2113
(904) 363-2606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
TRN13818
FL
207RH0003X
Hematology & Oncology Physician
Primary
ME122974
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014413900
—
FL
01
—
14ZM4
BC/BS
FL
Enumeration date
05/26/2009
Last updated
01/09/2024
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