Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | CL1267948 | FL |
NPI | 1144797580 |
---|---|
Provider Name | Ms. Stephanie M Bell |
First Address | Jacksonville, FL 32218-4506 |
Second Address | Jacksonville, FL 32218-4506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2018 |
Last Update Date | 24/10/2018 |