Individual
RAYMUNDO GAMBOA JACINTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701
(727) 767-3051
Mailing address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-3051
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
MA058757
PA
363AM0700X
Medical Physician Assistant
Primary
PA9111727
FL
Other
Enumeration date
11/14/2016
Last updated
01/31/2019
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