Healthcare Provider Details

I. General information

NPI: 1942393400
Provider Name (Legal Business Name): MYLINDA LEE BIELMAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14550 OLD SAINT AUGUSTINE RD
JACKSONVILLE FL
32258-2460
US

IV. Provider business mailing address

54 HORSETAIL CT
SAINT AUGUSTINE FL
32095-7608
US

V. Phone/Fax

Practice location:
  • Phone: 904-271-6000
  • Fax:
Mailing address:
  • Phone: 951-285-7205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20A7688
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number20A7688
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: