Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 11017573 | FL |
NPI | 1588316749 |
---|---|
Provider Name | Estrella Baxter |
First Address | Jacksonville, FL 32225-4806 |
Second Address | Jacksonville, FL 32216-4207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2022 |
Last Update Date | 19/01/2022 |