Itzel Sandoval-reynoso PA-C
Medical Physician Assistant in Jacksonville, FL(View on Map)
Full Name
Itzel Sandoval-reynoso PA-C
NPI Number
1356011514
NPI Type
Individual Provider
Gender
Female
Enumeration Date
09/17/2021
Specialties
(Taxonomies)Licenses
State
Florida
License Number
PA9115077
Contact
Information
Purpose
Mailing
Location
Address
6520 FORT CAROLINE RD
1215 DUNN AVE STE 1
City
Jacksonville
Jacksonville
State
FL
FL
Postal Code
32277-2044
32218-4897
Country
US
US
Telephone Number
(904) 745-3618
(904) 696-7474
Identifiers
Identifier
112060700
OF335
Identifier State
FL
FL
Identifier Issuer
Unknown
MEDICARE
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 04/04/2022