Individual
JACLYN TYO MELDRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5191 FIRST COAST TECH PKWY FL 3, JACKSONVILLE, FL 32224-0609
(904) 223-3321
(904) 223-2169
Mailing address
5191 FIRST COAST TECH PKWY FL 3, JACKSONVILLE, FL 32224-0609
(904) 223-3321
(904) 223-2169
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9103502
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292340800
—
FL
Enumeration date
04/07/2006
Last updated
10/14/2024
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