Individual
JACLYN PINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
600 S DIXIE HWY STE 103, BOCA RATON, FL 33432-6034
(561) 806-6835
(561) 806-6607
Mailing address
600 S DIXIE HWY STE 103, BOCA RATON, FL 33432-6034
(561) 430-3629
(561) 990-7435
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9112593
FL
Other
Enumeration date
11/27/2019
Last updated
01/09/2020
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