Individual
DESTENI MARIAH BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
150 LONGLEAF PINE PKWY STE 200, ST JOHNS, FL 32259-7529
(904) 398-7205
(904) 652-0811
Mailing address
4800 BELFORT RD, JACKSONVILLE, FL 32256-6004
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9108210
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/19/2014
Last updated
11/15/2024
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