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NPI Code Detail

MEDICARE: SYDNEY BALL DO

MEDICARE: SYDNEY BALL DO
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1811839178
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY BALL DO
Provider Business Mailing Address
First Line : 2627 RIVERSIDE AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32204-4717
Country : US
Telephone Number : 904-308-7372
Fax Number : 904-308-6909
Provider Business Practice Location Address
First Line : 2627 RIVERSIDE AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32204-4717
Country : US
Telephone Number : 904-308-7372
Fax Number : 904-308-6909
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “ SYDNEY BALL DO” Practice Location

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