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General NPI Number Information
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NPI Number | 1972918118
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Entity Type | Individual
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Provider Name | MARSELA HYSKA CAMPBELL DO
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Gender | Female
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 12/09/2021
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Provider Practice Location Address
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Address Line | 1111 COLOMBO ST
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City | JACKSONVILLE
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State | FL
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Zip | 32207-3013
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Country | US
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Telephone | 904-800-9151
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 COLOMBO ST
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City | JACKSONVILLE
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State | FL
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Zip | 32207-3013
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Country | US
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Telephone | 904-800-9151
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS13618
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 286603
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | UO4283
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DO00948
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License Number State | RI
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