Individual
JENNIFER LYNN RAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
77 W GRANADA BLVD, ORMOND BEACH, FL 32174-6302
(386) 677-0453
(386) 677-0463
Mailing address
77 W GRANADA BLVD, ORMOND BEACH, FL 32174-6302
(386) 677-0453
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9110633
FL
Other
Enumeration date
10/10/2017
Last updated
02/16/2018
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