Healthcare Provider Details

I. General information

NPI: 1477224079
Provider Name (Legal Business Name): JAMIE STECKLER PA-C, MMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAMIE BAKALAR PA-C, MMS

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 SW 87TH AVE STE 100
MIAMI FL
33173-5458
US

IV. Provider business mailing address

PO BOX 198054
ATLANTA GA
30384-8054
US

V. Phone/Fax

Practice location:
  • Phone: 786-204-4201
  • Fax:
Mailing address:
  • Phone: 786-594-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9114949
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: