Individual
MRS. JENNY MARIA DODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
922 E CALL ST, STARKE, FL 32091-3616
(904) 368-2300
(386) 292-8295
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(954) 377-3134
(865) 560-7377
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104645
FL
363A00000X
Physician Assistant
PAT9104645
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000339800
—
FL
Enumeration date
07/26/2008
Last updated
01/26/2015
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