Individual
JEREMY ANTONIO MINAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0301
(352) 627-4577
Mailing address
182 ALEXANDER WOODS DR, PLANT CITY, FL 33563-7112
(813) 650-6176
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9925
GA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104250700
—
FL
Enumeration date
05/08/2019
Last updated
03/08/2021
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