Individual
COURTNEY LEE-PAIGE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
515 S KINGS AVE STE 3000, BRANDON, FL 33511-6060
(813) 681-6625
(813) 684-6043
Mailing address
PO BOX 748817, ATLANTA, GA 30374-8817
(813) 286-0033
(813) 282-1806
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9115718
FL
363A00000X
Physician Assistant
PA9186
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113481200
—
FL
Enumeration date
02/15/2022
Last updated
06/03/2024
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