Individual
JEAN BERNARD LE GALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
190 E. INTENDENCIA STREET, SUITE A-28, PENSACOLA, FL 32502-5806
(850) 908-6810
Mailing address
PO BOX 17567, PENSACOLA, FL 32522-7567
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9111202
FL
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0249870000
—
FL
Enumeration date
10/28/2008
Last updated
07/31/2018
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