Female

Shela T. Mainor PA-C

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

Full Name

Shela Towanna Mainor PA-C

NPI Number

1437522638

NPI Type

Individual Provider

Gender

Female

Enumeration Date

11/10/2015

Specialties

(Taxonomies)

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Florida
Maryland

License Number

PA9109488
C06005

Contact
Information

Purpose

Mailing
Location

Address

4201 BELFORT RD
4201 BELFORT RD

City

Jacksonville
Jacksonville

State

FL
FL

Postal Code

32216-1431
32216-1431

Country

US
US

Telephone Number

(912) 248-2346
(912) 248-2346

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

Data last updated by provider on 09/03/2016

Provider Address

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