Provider Demographics
NPI:1497094247
Name:PARAFINCZUK, JENTRY L (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JENTRY
Middle Name:L
Last Name:PARAFINCZUK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 NE 123RD ST STE 417
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2885
Mailing Address - Country:US
Mailing Address - Phone:305-899-2511
Mailing Address - Fax:
Practice Address - Street 1:1801 NE 123RD ST STE 417
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2885
Practice Address - Country:US
Practice Address - Phone:305-899-2511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107097363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical