Mary Tice is a Medical in Jacksonville, Florida. Mary Tice practices all healthcare services and medical treatments related to Medical. The NPI Number for Mary Tice is 1073594206. The last update date is 2020-08-31.
Mary Tice's current location address is 4500 San Pablo Rd S, Jacksonville, Florida. You can contact this provider via phone number 9049532000. The mailing address for Mary Tice is 4500 San Pablo Rd S, Jacksonville, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Tice |
|---|---|
| Address | 4500 San Pablo Rd S, Jacksonville, Florida |
| Phone Number | 9049532000 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1073594206 |
|---|---|
| Provider Enumeration Date | 2005-11-05 |
| Last Updated Date | 2020-08-31 |
Provider Mailing Address Detail
| Address | 4500 San Pablo Rd S |
|---|---|
| City | Jacksonville |
| State | Florida (FL) |
| Post Code | 322241865 |
| Phone Number | 9049532000 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | PA9102441 |
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Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
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Post Comment/ Review Below
What is the unique provider identifier assigned to Mary Tice?
The Mary Tice has been issued the NPI (National Provider Identifier) 1073594206 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Mary Tice?
The Mary Tice is physically situated at 4500 San Pablo Rd S, in the city of Jacksonville, state of FL, with the postal code 322241865.
What is the Mary Tice's area of specialization and corresponding taxonomy classification?
The Mary Tice's specialty field is Medical, and it falls under the taxonomy code 363Am0700X, which categorizes healthcare providers based on their specialties.
On what date was the 1073594206 assigned to Mary Tice?
The Mary Tice was issued its 1073594206 on 2005-11-05, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Mary Tice last refreshed?
The information related to the Mary Tice, including its address, specialty, and other relevant details, was last updated on 2020-08-31.