Provider Demographics
NPI:1750413662
Name:SCARLETT, JEWEL R (MD)
Entity type:Individual
Prefix:
First Name:JEWEL
Middle Name:R
Last Name:SCARLETT
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3744 BLANDING BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-5243
Mailing Address - Country:US
Mailing Address - Phone:904-771-6256
Mailing Address - Fax:904-260-2653
Practice Address - Street 1:3744 BLANDING BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-5243
Practice Address - Country:US
Practice Address - Phone:904-771-6256
Practice Address - Fax:904-260-2653
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME57899207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE60466Medicare UPIN