Individual
JANET UNDERKOFLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1594 KINGSLEY AVE, ORANGE PARK, FL 32073-4546
(904) 264-8621
(904) 215-9418
Mailing address
1594 KINGSLEY AVE, ORANGE PARK, FL 32073-4546
(904) 264-8621
(904) 215-9418
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0001744
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002072500
—
FL
01
—
PA0001744
FL LICENSE
FL
Enumeration date
07/20/2005
Last updated
06/20/2024
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