Provider Demographics
NPI:1710932447
Name:ANTOINE, VERONICA M (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:M
Last Name:ANTOINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:D
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7855 ARGYLE FOREST BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-5597
Mailing Address - Country:US
Mailing Address - Phone:904-955-0562
Mailing Address - Fax:904-212-1351
Practice Address - Street 1:1361 13TH AVE S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3233
Practice Address - Country:US
Practice Address - Phone:904-265-7755
Practice Address - Fax:904-265-7754
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-13021207LP2900X
FLME134179207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000258830OtherHMSA BILLING NUMBER
FL022954100Medicaid
FLJE762ZOtherMEDICARE FL