Individual
BRENT THOMAS MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11701-32 SAN JOSE BLVD, SUITE 103, JACKSONVILLE, FL 32223-0756
(904) 880-0911
(904) 880-9388
Mailing address
11945 SAN JOSE BLVD, SUITE 300, JACKSONVILLE, FL 32223-1613
(904) 396-1725
(907) 399-1717
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9109612
FL
Other
Enumeration date
07/28/2016
Last updated
09/02/2016
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