Provider Demographics
NPI:1235227000
Name:O'CONNELL, FLORENCE MARIE-LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:FLORENCE
Middle Name:MARIE-LOUISE
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4776 HODGES BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-7217
Mailing Address - Country:US
Mailing Address - Phone:904-404-8555
Mailing Address - Fax:
Practice Address - Street 1:4776 HODGES BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-7217
Practice Address - Country:US
Practice Address - Phone:904-404-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN10056207R00000X
FLME104381207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRES000Medicare UPIN