Individual
GIDEON EZIAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
333 1ST ST N, SUITE 200, JACKSONVILLE BEACH, FL 32250-6945
(904) 694-1213
Mailing address
333 1ST ST N, SUITE 200, JACKSONVILLE BEACH, FL 32250-6945
(904) 694-1213
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R152418
MD
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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