MEDICARE: MARY LINDA TONER 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	207Q00000X	Family Medicine Physician	ARNP 9198361	FL

General Provider Information

NPI Number	:	1629140249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY LINDA TONER A.R.N.P.

Provider Business Mailing Address
First Line	:	PO BOX 45443
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84145-0443
Country	:	US
Telephone Number	:	904-202-1032
Fax Number	:	904-376-4107

Provider Business Practice Location Address
First Line	:	1922 UNIVERSITY BLVD S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-8933
Country	:	US
Telephone Number	:	904-721-7844
Fax Number	:	904-727-3597

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	12/12/2018

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