Female

Mary J. Sutherland P.A.-C

Medical Physician Assistant in Fleming Island, FL(View on Map)

Full Name

Mary Josephine Sutherland P.A.-C

NPI Number

1912927237

NPI Type

Individual Provider

Gender

Female

Enumeration Date

07/20/2006

Specialties

(Taxonomies)

Code

363AM0700X
363A00000X

Primary Taxonomy

Yes
No

Licenses

State

Florida

License Number

PA2225

Contact
Information

Purpose

Mailing
Location

Address

3189 HIGHWAY 17
3189 US HIGHWAY 17

City

Green Cove Springs
Fleming Island

State

FL
FL

Postal Code

32043-9371
32003-7109

Country

US
US

Telephone Number

(904) 621-0247
(904) 621-0247

Identifiers

Identifier

291115900

Identifier State

FL

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/21/2022

Provider Address

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