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General NPI Number Information
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NPI Number | 1659676435
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Entity Type | Individual
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Provider Name | JENNIFER LEIGH STRONG PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 1451 DUNBROOKE LOOP
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City | LONGWOOD
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State | FL
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Zip | 32779
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Country | US
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Telephone | 352-250-7430
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 952725
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City | LAKE MARY
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State | FL
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Zip | 32795
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Country | US
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Telephone | 352-250-7430
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 9105782
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License Number State | FL
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