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General NPI Number Information
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NPI Number | 1619995388
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Entity Type | Individual
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Provider Name | JENNIFER L MADDEN MD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 45 GROOVER LOOP STE 201
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-6586
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Country | US
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Telephone | 904-634-0640
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Fax | 904-634-0203
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Provider Business Mailing Address
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Address Line | 6800 SOUTHPOINT PKWY STE 300
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City | JACKSONVILLE
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State | FL
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Zip | 32216-8203
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Country | US
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Telephone | 904-634-0640
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Fax | 904-634-0203
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME99389
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | ME99389
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | ME99389
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | ME99389
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License Number State | FL
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