MEDICARE: ANNA RUTH-MILDRED NEW

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	363A00000X	Physician Assistant	PA9110750	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	:	1831613165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA RUTH-MILDRED NEW

Provider Business Mailing Address
First Line	:	3625 UNIVERSITY BLVD S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4207
Country	:	US
Telephone Number	:	904-702-6089
Fax Number	:

Provider Business Practice Location Address
First Line	:	3625 UNIVERSITY BLVD S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4222
Country	:	US
Telephone Number	:	904-702-6089
Fax Number	:

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

Provider Enumeration Date	:	07/28/2017
Last Update Date	:	12/03/2024

Similar Medicare Providers

1770014714 — DR. JIMMY CAMARGO DOURADO M.D.
Practice Location Address:

3625 UNIVERSITY BLVD S
JACKSONVILLE, FL
32216-4222

Practice Phone: 904-702-6111
Practice Fax:

1639839988 — DR. BRYAN LAZETTE CRNA
Practice Location Address:

3625 UNIVERSITY BLVD S
JACKSONVILLE, FL
32216-4222

Practice Phone: 727-504-6618
Practice Fax:

1558242008 — TYLER JACKSON
Practice Location Address:

3625 UNIVERSITY BLVD S
JACKSONVILLE, FL
32216-4222

Practice Phone: 904-702-6156
Practice Fax:

1679521488 — DR. DMITRIY MODEL M.D.
Practice Location Address:

1633 RACE TRACK RD , SUITE 1
JACKSONVILLE, FL
32259-4222

Practice Phone: 904-230-6988
Practice Fax: 904-342-4028

1538419734 — ROBERT E DUNCAN MD
Practice Location Address:

900 ORIENTAL GARDENS RD
JACKSONVILLE, FL
32207-4222

Practice Phone: 904-399-3000
Practice Fax:

1689305427 — MRS. STEPHANIE RAE TAYLOR LCSW
Practice Location Address:

12340 WOOD BLOSSOM CT
JACKSONVILLE, FL
32246-4222

Practice Phone: 904-458-6031
Practice Fax:

Directions to “ ANNA RUTH-MILDRED NEW ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.