Individual
MS. JESSICA R POULIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2979 PGA BLVD STE 100, PALM BEACH GARDENS, FL 33410
(561) 626-3800
(561) 624-6364
Mailing address
770 NORTHPOINT PKWY STE 102, WEST PALM BEACH, FL 33407-1901
(561) 275-7604
(561) 802-5385
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
TRN15983
FL
207VM0101X
Maternal & Fetal Medicine Physician
Primary
ME119737
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015052200
—
FL
Enumeration date
05/27/2011
Last updated
08/29/2018
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