Provider Demographics
NPI:1720267149
Name:VALENTIN, JENNIFER (PA-C, DMS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:VALENTIN
Suffix:
Gender:F
Credentials:PA-C, DMS
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:CAMACHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:626 NEPTUNE DR
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:FL
Mailing Address - Zip Code:34736-9687
Mailing Address - Country:US
Mailing Address - Phone:239-246-4494
Mailing Address - Fax:
Practice Address - Street 1:835 OAKLEY SEAVER DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1968
Practice Address - Country:US
Practice Address - Phone:321-238-8048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107458363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant