Individual
CHRISTINE M MACKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-8480
Mailing address
3629 EL CAMINO CT, LARGO, FL 33771-2779
(757) 651-4849
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9110833
FL
363AM0700X
Medical Physician Assistant
0110003933
VA
Other
Enumeration date
07/18/2012
Last updated
03/09/2022
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