Individual
MS. IRINA JOSEPHOVNA PICHKHADZE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
580 W 8TH ST, UFJP PLASTIC SURGERY, JACKSONVILLE, FL 32209-6533
(904) 244-9714
(904) 354-9070
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103405
FL
Other
Enumeration date
02/19/2006
Last updated
07/08/2007
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