Individual
MR. CLYDE JUNIOR PITCAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MPAS
Contact information
Practice address
2401 E STREET NW, SA-1 (OFFICE OF MEDICAL SERVICES U.S. DEPT OF STATE), WASHINGTON, DC 20522-0001
(954) 630-1114
(954) 630-1155
Mailing address
5385 RED LEAF CT, OVIEDO, FL 32765-5019
(954) 630-1114
(954) 630-1155
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101860
FL
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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