Individual
ALICIA MAILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
550 SCRUB JAY DR, ST AUGUSTINE, FL 32092-1751
(904) 501-4236
Mailing address
550 SCRUB JAY DR, ST AUGUSTINE, FL 32092-1751
(904) 501-4236
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9272850
FL
363LF0000X
Family Nurse Practitioner
Primary
11025568
FL
Other
Enumeration date
03/31/2023
Last updated
11/03/2024
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