MEDICARE: MEGAN MESSER

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	363AM0700X	Medical Physician Assistant	PA9109891	FL

General Provider Information

NPI Number	:	1235688359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MESSER

Provider Business Mailing Address
First Line	:	2151 RIVERSIDE AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4416
Country	:	US
Telephone Number	:	904-388-8686
Fax Number	:

Provider Business Practice Location Address
First Line	:	3627 UNIVERSITY BLVD S
Second Line	:	SUITE 430
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4230
Country	:	US
Telephone Number	:	904-858-9700
Fax Number	:

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

Provider Enumeration Date	:	09/30/2016
Last Update Date	:	09/30/2016

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Directions to “ MEGAN MESSER ” Practice Location

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