Provider Information for 1235789868
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MOLLY SANDERS
Sex: Female
NPI: 1235789868
Last Updated: 2023-08-21
Certification Date: 2023-08-21
Certification Date: 2023-08-21
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1235789868 | ||||||||||||||
| Enumeration Date | 2019-09-16 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 5776 SAINT AUGUSTINE RD JACKSONVILLE, FL 32207-8046 United States Phone: 904-448-4700 | Fax: | ||||||||||||||
| Primary Practice Address | 5776 SAINT AUGUSTINE RD JACKSONVILLE, FL 32207-8046 United States Phone: 904-448-4700 | Fax: | ||||||||||||||
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