Individual
MEGAN DELA REA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11545 PETERSHAM FALLS LN, JACKSONVILLE, FL 32258-2514
(904) 993-7504
Mailing address
11545 PETERSHAM FALLS LN, JACKSONVILLE, FL 32258-2514
(904) 993-7504
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9116141
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/27/2020
Last updated
12/05/2022
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