Individual
EVALEEN FAYE CACCAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4425 MERRIMAC AVE, JACKSONVILLE, FL 32210-1850
(904) 346-0050
(904) 346-0080
Mailing address
4425 MERRIMAC AVE, JACKSONVILLE, FL 32210-1850
(904) 346-0050
(904) 346-0080
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
ME89729
FL
207VG0400X
Gynecology Physician
Primary
ME89729
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269890100
—
FL
Enumeration date
07/21/2006
Last updated
02/20/2024
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