Individual
CARLOS HUMBERTO JAEN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2000 SW 27TH AVE # 301, MIAMI, FL 33145-2546
(305) 461-2010
(305) 648-0140
Mailing address
1685 SW 17TH TER, MIAMI, FL 33145-2809
(305) 742-9121
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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