Individual
CARLOS HUMBERTO JAEN SR.
Active
Individual
CARLOS HUMBERTO JAEN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
PA9112833
FL
207KA0200X
Allergy Physician
PA9112833
FL
363AM0700X
Medical Physician Assistant
Primary
PA9112833
FL
Other
Enumeration date
06/25/2020
Last updated
07/02/2024
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