Individual
JOAN DUNSTONE O LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1555 KINGSLEY AVE, SUITE 401, ORANGE PARK, FL 32073-9204
(904) 278-3100
(904) 278-4463
Mailing address
1555 KINGSLEY AVE, SUITE 401, ORANGE PARK, FL 32073-9204
(904) 278-3100
(904) 278-4463
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME0064412
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18934
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/12/2006
Last updated
07/08/2007
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