Individual
JACLYN MARIE PENNINGTON ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
204 E 19TH ST, PANAMA CITY, FL 32405-4707
(850) 763-5409
Mailing address
4601 E LAKELAND DR, PANAMA CITY, FL 32404-5219
(850) 625-0562
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 9105851
FL
Other
Enumeration date
12/20/2011
Last updated
09/12/2024
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