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Individual

JACQUELYN LEE WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
5850 CORAL RIDGE DR, SUITE 106, CORAL SPRINGS, FL 33076-3378
(954) 714-8200
(954) 840-2626
Mailing address
5850 CORAL RIDGE DR, SUITE 106, CORAL SPRINGS, FL 33076-3378
(954) 714-8200
(954) 840-2626

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363AM0700X
Medical Physician Assistant
363AS0400X
Surgical Physician Assistant

Other

Enumeration date
01/31/2013
Last updated
01/31/2013
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