Individual
MS. JENNA R DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21550 BISCAYNE BLVD STE 202A, AVENTURA, FL 33180-1258
(057) 070-3683
Mailing address
15280 NW 79TH CT STE 200, MIAMI LAKES, FL 33016-5873
(305) 558-3724
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9116691
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2021
Last updated
02/06/2023
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