MEDICARE: CAROL M GARNER APRN

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	363LA2200X	Adult Health Nurse Practitioner	2722252	FL

General Provider Information

NPI Number	:	1952353567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL M GARNER APRN

Provider Business Mailing Address
First Line	:	4123 UNIVERSITY BLVD S
Second Line	:	STE B
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216
Country	:	US
Telephone Number	:	904-636-9100
Fax Number	:	904-636-9102

Provider Business Practice Location Address
First Line	:	4123 UNIVERSITY BLVD S
Second Line	:	STE B
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216
Country	:	US
Telephone Number	:	904-636-9100
Fax Number	:	904-636-9102

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	09/27/2019

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