MEDICARE: MISS CANDACE J PARMER

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	174H00000X	Health Educator		FL

General Provider Information

NPI Number	:	1720631823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CANDACE J PARMER

Provider Business Mailing Address
First Line	:	4205 BELFORT RD STE 1005
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-5876
Country	:	US
Telephone Number	:	904-450-6450
Fax Number	:	904-450-6451

Provider Business Practice Location Address
First Line	:	4205 BELFORT RD STE 1005
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-5876
Country	:	US
Telephone Number	:	904-450-6450
Fax Number	:	904-450-6451

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

Provider Enumeration Date	:	07/18/2019
Last Update Date	:	07/18/2019

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Directions to “ MISS CANDACE J PARMER ” Practice Location

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