MEDICARE: JACKLYN HEJEILE 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	PA9117849	FL

General Provider Information

NPI Number	:	1962277749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACKLYN HEJEILE PA-C

Provider Business Mailing Address
First Line	:	7405 PARK LANE RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33449-6702
Country	:	US
Telephone Number	:	561-801-0517
Fax Number	:

Provider Business Practice Location Address
First Line	:	603 VILLAGE BLVD STE 202
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1972
Country	:	US
Telephone Number	:	561-499-9000
Fax Number	:

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

Provider Enumeration Date	:	11/21/2023
Last Update Date	:	04/02/2026

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