Most Relevant Information
Provider Data
| NPI Number: | 1003598368 |
| Provider Name: | MARK LATHROP |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | RN9415770 |
Most Important Dates
| Enumeration Date: | 08/04/2023 |
| Last Updated: | 08/04/2023 |
Provider Practice Location
2449 BLACKBEARD DR
JACKSONVILLE
FL
322241139
Practice Location Phone/Fax
| Phone: | 9042380070 |
| Fax: |
Provider Mailing Location
2449 BLACKBEARD DR
JACKSONVILLE
FL
322241139
Provider Mailing Phone/Fax
| Phone: | 9042380070 |
| Fax: |