Provider Demographics
NPI:1205908068
Name:JOEMMANKHAN, RASHIDA NATACHA (PA-C)
Entity type:Individual
Prefix:
First Name:RASHIDA
Middle Name:NATACHA
Last Name:JOEMMANKHAN
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 1:1017 SW 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-7232
Mailing Address - Country:US
Mailing Address - Phone:305-321-9034
Mailing Address - Fax:
Practice Address - Street 1:5067 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-4000
Practice Address - Country:US
Practice Address - Phone:954-267-1621
Practice Address - Fax:954-267-1625
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102718208000000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No208000000XAllopathic & Osteopathic PhysiciansPediatrics