Individual
DORJANA ISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006075
MI
363A00000X
Physician Assistant
PA9108870
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003186089A
—
GA
05
—
019981400
—
FL
Enumeration date
09/16/2011
Last updated
08/31/2020
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