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NPI Code Detail

MEDICARE: CAROL MARSHALL

MEDICARE: CAROL MARSHALL
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
1261QD1600XDevelopmental Disabilities Clinic/Center

General Provider Information

NPI Number : 1235683376
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL MARSHALL
Provider Business Mailing Address
First Line : 1248 EDGEWOOD AVE W STE 3
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32208-2874
Country : US
Telephone Number : 904-438-0605
Fax Number : 904-586-2223
Provider Business Practice Location Address
First Line : 1248 EDGEWOOD AVE W STE 3
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32208-2874
Country : US
Telephone Number : 904-438-0605
Fax Number : 904-586-2223
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2016
Last Update Date : 10/02/2025

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Directions to “ CAROL MARSHALL ” Practice Location

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