Provider Demographics
NPI:1528536810
Name:RAMADAN, JIHAN INEZ (PA)
Entity Type:Individual
Prefix:
First Name:JIHAN
Middle Name:INEZ
Last Name:RAMADAN
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 1:3307 POMEROL DR APT 408
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-9420
Mailing Address - Country:US
Mailing Address - Phone:954-292-4717
Mailing Address - Fax:
Practice Address - Street 1:2655 S STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-9377
Practice Address - Country:US
Practice Address - Phone:561-323-4267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110852363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical