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Individual
JACLYN BALOGA
Active
Individual
JACLYN BALOGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107884
FL
363AS0400X
Surgical Physician Assistant
014089
NY
363AS0400X
Surgical Physician Assistant
MA053542
PA
Other
Enumeration date
09/24/2008
Last updated
12/04/2020
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