Provider Demographics
NPI:1093051088
Name:GALINAITIS, JACLYN PATRICIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:PATRICIA
Last Name:GALINAITIS
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:7225 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2908
Mailing Address - Country:US
Mailing Address - Phone:954-718-9777
Mailing Address - Fax:954-718-0233
Practice Address - Street 1:7225 N UNIVERSITY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2908
Practice Address - Country:US
Practice Address - Phone:954-718-9777
Practice Address - Fax:954-718-0233
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9106426363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical