Healthcare Provider Details

I. General information

NPI: 1013913854
Provider Name (Legal Business Name): ANNETTE DAVIDSON BELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PRUDENTIAL DR
JACKSONVILLE FL
32207-8202
US

IV. Provider business mailing address

820 PRUDENTIAL DR STE 713
JACKSONVILLE FL
32207-8209
US

V. Phone/Fax

Practice location:
  • Phone: 904-396-5682
  • Fax: 904-346-0864
Mailing address:
  • Phone: 904-396-5682
  • Fax: 904-346-0864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP01002100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME95562
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MP01002100
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number49769
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: