Provider Demographics
NPI:1659150936
Name:AUERBACH, JASMINE (PA)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:AUERBACH
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 1:14720 JOCKEY CIR S
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-1019
Mailing Address - Country:US
Mailing Address - Phone:786-781-9210
Mailing Address - Fax:
Practice Address - Street 1:323 SUNNY ISLES BLVD STE 106
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4672
Practice Address - Country:US
Practice Address - Phone:786-781-9210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant