MEDICARE: ANAEL DJAKER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA9116410	FL

General Provider Information

NPI Number	:	1043808157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANAEL DJAKER PA-C

Provider Business Mailing Address
First Line	:	3051 BIRD LN
Second Line	:
City	:	WINDERMERE
State	:	FL
Zip	:	34786-8349
Country	:	US
Telephone Number	:	407-765-1827
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 NW 12TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1005
Country	:	US
Telephone Number	:	954-423-9234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2021
Last Update Date	:	12/08/2025

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