Provider Demographics
NPI:1003131988
Name:JACINTO, PAULINE LAGGUI (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULINE
Middle Name:LAGGUI
Last Name:JACINTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 STARLING STREET
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520
Mailing Address - Country:US
Mailing Address - Phone:912-466-5196
Mailing Address - Fax:912-466-5197
Practice Address - Street 1:2500 STARLING STREET
Practice Address - Street 2:SUITE 304
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520
Practice Address - Country:US
Practice Address - Phone:912-466-5196
Practice Address - Fax:912-466-5197
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115095174400000X
GA70316174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist