Individual
ELISABETH JACQUELINE GUILLEMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6573 A1A S, SAINT AUGUSTINE, FL 32080-7504
(904) 342-7363
Mailing address
33 GROVE AVE, APT A, SAINT AUGUSTINE, FL 32084-3251
(575) 770-4828
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAT-9109926
FL
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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