Most Relevant Information
Provider Data
| NPI Number: | 1003383456 |
| Provider Name: | EBONY S PRESCOTT PRACTITIONER |
| Entity Type: | Individual |
| Taxonomy Code: | 1744P3200X |
| Specialty: | Specialist |
| License Number: | AEC-17-05264 |
Most Important Dates
| Enumeration Date: | 10/24/2018 |
| Last Updated: | 11/02/2023 |
Provider Practice Location
3100 UNIVERSITY BLVD S STE 109
JACKSONVILLE
FL
322162737
Practice Location Phone/Fax
| Phone: | 9048462160 |
| Fax: |
Provider Mailing Location
3100 UNIVERSITY BLVD S STE 109
JACKSONVILLE
FL
322162737
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |