Provider Demographics
NPI:1750916359
Name:SATTERFIELD, TRAVIS COLEMAN (PA-C)
Entity type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:COLEMAN
Last Name:SATTERFIELD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:MR
Other - First Name:COLBY
Other - Middle Name:
Other - Last Name:SATTERFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:4800 BELFORT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6004
Mailing Address - Country:US
Mailing Address - Phone:904-398-7205
Mailing Address - Fax:
Practice Address - Street 1:3635 CLYDE MORRIS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-2349
Practice Address - Country:US
Practice Address - Phone:386-788-1242
Practice Address - Fax:386-756-8802
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-04
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9113092363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical