Individual
LOAN LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
653 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 383-1014
(904) 244-5090
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 383-1014
(904) 244-5090
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
OS17976
FL
Other
Enumeration date
04/08/2018
Last updated
03/10/2025
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