Individual
MRS. JENNIFER RAE GERGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
508 N MARYLAND AVE., PLANT CITY FAMILY CARE, PLANT CITY, FL 33563
(813) 349-7600
Mailing address
3123 OLIVIA CT, LAND O LAKES, FL 34638
(813) 503-8217
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
FLPA9101586
FL
363AM0700X
Medical Physician Assistant
PA9101586
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291018700
—
FL
Enumeration date
07/18/2006
Last updated
12/21/2012
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