Provider Demographics
NPI:1093728016
Name:BUDAY, PAMELA (PA)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:BUDAY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD
Mailing Address - Street 2:JOE ADAMS BLDG, SUITE 4020
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1471
Mailing Address - Country:US
Mailing Address - Phone:904-450-6444
Mailing Address - Fax:904-296-9542
Practice Address - Street 1:4205 BELFORT RD
Practice Address - Street 2:JOE ADAMS BLDG, SUITE 2069
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1471
Practice Address - Country:US
Practice Address - Phone:904-296-0278
Practice Address - Fax:904-296-0279
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2373363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS62810Medicare UPIN
FLE1186XMedicare ID - Type Unspecified