Individual
JACQUELINE SQUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
ME136920
FL
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
04/07/2015
Last updated
08/31/2020
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