Individual
BONNIE JEAN GANDEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14534 OLD SAINT AUGUSTINE RD STE 3420, JACKSONVILLE, FL 32258-2616
(904) 493-8001
(904) 338-0852
Mailing address
PO BOX 43667, JACKSONVILLE, FL 32203-3667
(904) 720-0599
(904) 376-4036
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9101664
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01086308
RAILROAD MEDICARE
FL
Enumeration date
07/16/2006
Last updated
03/31/2020
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