Jackie Floyd Hagenbaumer, | |
655 W 8th St, Jacksonville, FL 32209-6511 | |
(904) 244-0411 | |
Not Available |
Full Name | Jackie Floyd Hagenbaumer |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 655 W 8th St, Jacksonville, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710691274 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 11023863 (Florida) | Primary |
Entity Name | University Of Florida Jacksonville Physicians, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1144276452 PECOS PAC ID: 9133025869 Enrollment ID: O20040128000786 |
Mailing Address | Practice Location Address |
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Jackie Floyd Hagenbaumer, 9479 Heckscher Dr, Jacksonville, FL 32226-2420 Ph: (352) 214-4761 | Jackie Floyd Hagenbaumer, 655 W 8th St, Jacksonville, FL 32209-6511 Ph: (904) 244-0411 |
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