Organization
KELLY DEMUYNCK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADELYN RAYOS (ADMINISTRATIVE ASSISTANT)
(850) 444-4777
Entity
Organization
Contact information
Practice address
4012 N 9TH AVE, PENSACOLA, FL 32503-2824
(850) 444-4777
(850) 434-3387
Mailing address
4012 N 9TH AVE, PENSACOLA, FL 32503-2824
(850) 444-4777
(850) 434-3387
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/24/2014
Last updated
04/24/2014
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