Female

Mary Tice PA

Medical Physician Assistant in Jacksonville, FL(View on Map)

Full Name

Mary Tice PA

NPI Number

1073594206

NPI Type

Individual Provider

Gender

Female

Enumeration Date

11/05/2005

Specialties

(Taxonomies)

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

PA9102441

Contact
Information

Purpose

Mailing
Location

Address

4500 SAN PABLO RD S
4500 SAN PABLO RD S

City

Jacksonville
Jacksonville

State

FL
FL

Postal Code

32224-1865
32224-1865

Country

US
US

Telephone Number

N/A
(904) 953-2000

Health Information Exchange

Endpoint Type

DIRECT

Endpoint

mtice397412@ehrdirect.mayoclinicmsg.org

Endpoint Description

Unknown

Use

Unknown

Content Type

Unknown

Affiliation

N

Endpoint Location

4500 San Pablo Rd SJacksonville, FL322241865US

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

Data last updated by provider on 08/31/2020

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