Rendon, Jacqueline
Rendon, Jacqueline is an individual health care provider with primary practice located at 10300 Sw 216Th St , Cutler Bay FL 33190-1003. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Rendon, Jacqueline can be contacted via phone (305) 253-5100.Contact Information
Primary practice address
10300 Sw 216Th St
Cutler Bay FL 33190-1003
Phone: (305) 253-5100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA9113800 | Florida |
Profile Details
| NPI number | 1881280964 |
|---|---|
| LBN Legal business name | Rendon, Jacqueline |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 14th, 2020 |
| Last updated | Feb 21st, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881280964 | NPPES |
| Florida | MEDICAID | 113273500 |
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