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Individual

JACQUELYN MONZON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
16161 NW 57TH AVE, HIALEAH, FL 33014-6707
(305) 625-3409
(305) 625-2734
Mailing address
16161 NW 57TH AVE, HIALEAH, FL 33014-6707
(305) 625-3409
(305) 625-2734

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-9106309
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA-9106309
STATE LICSENCE
FL
Enumeration date
02/29/2012
Last updated
02/29/2012
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