MEDICARE: MARA HEALTH CENTERS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	364SF0001X	Family Health Clinical Nurse Specialist
2	364SP0200X	Pediatric Clinical Nurse Specialist
3	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1265844823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARA HEALTH CENTERS LLC

Provider Business Mailing Address
First Line	:	6817 SOUTHPOINT PKWY STE 1704
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6298
Country	:	US
Telephone Number	:	904-999-4968
Fax Number	:

Provider Business Practice Location Address
First Line	:	6817 SOUTHPOINT PKWY STE 1704
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6298
Country	:	US
Telephone Number	:	904-999-4968
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MISS AMY ELIZABETH PRITCHETT
Credential	:
Telephone Number	:	904-999-4968

Provider Enumeration Date	:	05/29/2014
Last Update Date	:	11/20/2014

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Directions to “MARA HEALTH CENTERS LLC ” Practice Location

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