Individual
DR. GAELYN ELIZABETH LEE SCUDERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
655 W. 8TH STREET, UNIVERSITY OF FLORIDA DEPARTMENT OF RADIOLOGY, JACKSONVILLE, FL 32209
(904) 244-4225
Mailing address
PO BOX 44008, PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 383-1024
(904) 244-4946
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME92004
FL
2085R0203X
Therapeutic Radiology Physician
ME92004
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003129253A
—
GA
05
—
007197400
—
FL
01
—
14N7A
BCBS
FL
Enumeration date
02/07/2006
Last updated
06/07/2013
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