Individual
JEFFREY N. HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 258-3561
Mailing address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 258-3561
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106843
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007374800
—
FL
Enumeration date
09/25/2012
Last updated
11/20/2024
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