MEDICARE: MRS. REBECCA ANN DIDI A.R.N.P.

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	363LF0000X	Family Nurse Practitioner	ARNP2842542	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	:	1306862958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA ANN DIDI A.R.N.P.

Provider Business Mailing Address
First Line	:	705 WELLS RD STE 300
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-2982
Country	:	US
Telephone Number	:	905-282-6331
Fax Number	:	904-282-4117

Provider Business Practice Location Address
First Line	:	7855 ARGYLE FOREST BLVD
Second Line	:	SUITE 601
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-5596
Country	:	US
Telephone Number	:	904-778-3389
Fax Number	:	904-778-3395

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

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	12/09/2021

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Directions to “ MRS. REBECCA ANN DIDI A.R.N.P.” Practice Location

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