Individual
EMILY G JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
699 W COCOA BEACH CSWY, SUITE 403, COCOA BEACH, FL 32931-3577
(321) 868-8348
(321) 868-8349
Mailing address
PO BOX 561600, ROCKLEDGE, FL 32956-1600
(321) 434-4600
(321) 259-0635
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103794
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292606700
—
FL
01
—
PA9103794
LICENSE
FL
Enumeration date
10/20/2006
Last updated
05/18/2012
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