Female

Miss Wagma Qazizada PA-C

Physician Assistant in Jacksonville, FL(View on Map)

Full Name

Miss Wagma Qazizada PA-C

NPI Number

1730499062

NPI Type

Individual Provider

Gender

Female

Enumeration Date

10/20/2010

Specialties

(Taxonomies)

Code

363A00000X
363AM0700X

Primary Taxonomy

Yes
No

Licenses

State

Florida

License Number

PA9105608

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 43667
14534 OLD SAINT AUGUSTINE RD STE 3420

City

Jacksonville
Jacksonville

State

FL
FL

Postal Code

32203-3667
32258-2645

Country

US
US

Telephone Number

(904) 720-0599
(904) 493-8001

Identifiers

Identifier

004252400

Identifier State

FL

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/11/2020

Provider Address

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