Provider Demographics
NPI:1447565882
Name:MISHKIN, JILL A (PA)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:A
Last Name:MISHKIN
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Gender:F
Credentials:PA
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Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:1150 N 35TH AVE
Practice Address - Street 2:SUITE555
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5424
Practice Address - Country:US
Practice Address - Phone:954-265-0072
Practice Address - Fax:954-981-0188
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2021-03-22
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Provider Licenses
StateLicense IDTaxonomies
FLPA9105519363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant