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NPI Code Detail

MEDICARE: MRS. JEANTILAIR DULAURIER SR. PA

MEDICARE:  MRS. JEANTILAIR  DULAURIER SR. PA
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
1363A00000XPhysician Assistant
2363A00000XPhysician Assistant10222AZ

General Provider Information

NPI Number : 1902662240
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JEANTILAIR DULAURIER SR. PA
Provider Business Mailing Address
First Line : 11970 NE 16TH AVE
Second Line : APT 305
City : MIAMI
State : FL
Zip : 33161-6652
Country : US
Telephone Number : 786-319-0221
Fax Number :
Provider Business Practice Location Address
First Line : 11970 NE 16TH AVE APT 305
Second Line :
City : MIAMI
State : FL
Zip : 33161-6652
Country : US
Telephone Number : 786-319-0221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2024
Last Update Date : 02/26/2024

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Directions to “ MRS. JEANTILAIR DULAURIER SR. PA” Practice Location

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