Individual
MRS. JADE MARIE MEDDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EMT-B
Contact information
Practice address
725 DUNLAWTON AVE, #291938, PORT ORANGE, FL 32129-7001
(386) 562-4070
(386) 492-6941
Mailing address
PO BOX 291938, PORT ORANGE, FL 32129-1938
(386) 562-4070
(386) 760-0532
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
EMT509305
FL
183700000X
Pharmacy Technician
280101040340690
DC
Other
Enumeration date
12/11/2012
Last updated
10/04/2016
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