Individual
JENISSA DENEE LEITE DA SILVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
61 MEMORIAL MEDICAL PKWY STE 2811, PALM COAST, FL 32164-5999
(386) 586-1955
(386) 586-1959
Mailing address
PO BOX 935921, ATLANTA, GA 31193-5921
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9113699
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OE838
MEDICARE HF
FL
Enumeration date
10/07/2020
Last updated
03/25/2026
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