Healthcare Provider Details

I. General information

NPI: 1720669815
Provider Name (Legal Business Name): ANNA ROSE WARD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA ROSE HINRICHS

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PRUDENTIAL DR
JACKSONVILLE FL
32207-8202
US

IV. Provider business mailing address

1431 RIVERPLACE BLVD APT 3602
JACKSONVILLE FL
32207-9126
US

V. Phone/Fax

Practice location:
  • Phone: 904-202-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS21103
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: