Individual
CG DJALENTTA JACKIE KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(407) 633-2686
Mailing address
2043 WAVY LEAF CT, APOPKA, FL 32712-5015
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/27/2025
Last updated
05/27/2025
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