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NPI Code Detail

MEDICARE: MS. JENNIFER ANNE UDZINSKI MS PA-C

MEDICARE: MS. JENNIFER ANNE UDZINSKI MS 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
1363AM0700XMedical Physician AssistantPA9102799FL

General Provider Information

NPI Number : 1144328238
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER ANNE UDZINSKI MS PA-C
Provider Business Mailing Address
First Line : 4981 SW SAINT CREEK DR
Second Line :
City : PALM CITY
State : FL
Zip : 34990-8815
Country : US
Telephone Number : 772-631-6493
Fax Number :
Provider Business Practice Location Address
First Line : 938 SW MARTIN DOWNS BLVD
Second Line :
City : PALM CITY
State : FL
Zip : 34990-2816
Country : US
Telephone Number : 772-223-6410
Fax Number : 772-223-0092
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 09/27/2010

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