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General NPI Number Information
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NPI Number | 1780403733
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Entity Type | Individual
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Provider Name | JAMIE PACK PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 9111 PARK DR
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City | MIAMI SHORES
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State | FL
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Zip | 33138-3159
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Country | US
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Telephone | 970-778-0035
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Fax |
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Provider Business Mailing Address
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Address Line | 8001 SW 63RD CT
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-8020
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Country | US
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Telephone | 970-778-0035
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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 |
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License Number State |
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