MEDICARE: MS. CLAUDIA VANSOEST PHYSICIAN ASSISTANT

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	363AM0700X	Medical Physician Assistant	PA2632	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	:	1821263732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CLAUDIA VANSOEST PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	3033 MONUMENT RD STE 20
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-1779
Country	:	US
Telephone Number	:	904-642-1888
Fax Number	:	904-642-2019

Provider Business Practice Location Address
First Line	:	3033 MONUMENT RD STE 20
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-1779
Country	:	US
Telephone Number	:	904-642-1888
Fax Number	:	904-642-2019

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

Provider Enumeration Date	:	04/23/2008
Last Update Date	:	02/28/2013

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Directions to “ MS. CLAUDIA VANSOEST PHYSICIAN ASSISTANT” Practice Location

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