MEDICARE: DR. CHANDRA ALARICE ADAMS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ME96125	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	ME96125	OTHER	FL	FLORIDA MEDICAL LICENSE

General Provider Information

NPI Number	:	1104858034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHANDRA ALARICE ADAMS MD

Provider Business Mailing Address
First Line	:	6871 BELFORT OAKS PL
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6242
Country	:	US
Telephone Number	:	904-674-0022
Fax Number	:	904-425-0192

Provider Business Practice Location Address
First Line	:	6871 BELFORT OAKS PL
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6242
Country	:	US
Telephone Number	:	904-674-0022
Fax Number	:	904-425-0192

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	07/18/2019

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