Individual
MRS. JEAN FAIRCHILD BLYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5979 VINELAND RD STE 101, ORLANDO, FL 32819-7860
(407) 355-3120
(407) 355-3119
Mailing address
5979 VINELAND RD STE 101, ORLANDO, FL 32819-7860
(407) 355-3120
(407) 355-3119
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25402
NY
363A00000X
Physician Assistant
Primary
PAT 9106844
FL
Other
Enumeration date
10/02/2012
Last updated
07/03/2023
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