MEDICARE: KRISTIE DRIVER M.D.,M.P.H

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME131477	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003227141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIE DRIVER M.D.,M.P.H

Provider Business Mailing Address
First Line	:	5011 GATE PKWY BLDG 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-0830
Country	:	US
Telephone Number	:	904-523-3351
Fax Number	:	904-523-3340

Provider Business Practice Location Address
First Line	:	5011 GATE PKWY BLDG 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-0830
Country	:	US
Telephone Number	:	904-523-3351
Fax Number	:	904-523-3340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2014
Last Update Date	:	01/08/2026

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Directions to “ KRISTIE DRIVER M.D.,M.P.H” Practice Location

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