Individual
GHAZAL S VAFABAKHSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 PALM AVE, JACKSONVILLE, FL 32207-8432
(904) 202-7300
(904) 202-7433
Mailing address
PO BOX 45278, JACKSONVILLE, FL 32232-5278
(904) 202-2092
(904) 393-7603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9112314
FL
Other
Enumeration date
03/28/2019
Last updated
10/01/2020
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