Healthcare Provider Details

I. General information

NPI: 1194662049
Provider Name (Legal Business Name): PATRIA JUZANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E 23RD ST STE 1B
PANAMA CITY FL
32405-5301
US

IV. Provider business mailing address

19889 TURNER LN
TONEY AL
35773-7682
US

V. Phone/Fax

Practice location:
  • Phone: 850-872-1200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: