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Mirian Antelo Couch, PA-C
Medical Physician Assistant in Jacksonville, Florida
NPI 1881938991

Mirian Antelo Couch is a Medical Physician Assistant based in Jacksonville, FL and is specialized in Medical. Mirian Antelo Couch practices in Jacksonville, FL and has the professional credentials of PA-C. The NPI Number for Mirian Antelo Couch is 1881938991 and holds a License No. PA9106827 (Florida).

The current practice location address for Mirian Antelo Couch is 6555 Chester Ave Ste 1, Jacksonville, FL and can be reached out via phone at 904-309-6504 and via fax at 904-503-3577.

Location: 6555 Chester Ave Ste 1, Jacksonville, FL, 32217-2279
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Provider Profile Details
NPI Number
1881938991
Provider Name
Mirian Antelo Couch
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
6555 Chester Ave Ste 1, Jacksonville, FL, 32217-2279
Phone Number
904-309-6504
Fax Number
904-503-3577
Provider Enumeration Date
11/15/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100513100 05 FL
Y0FR9 01 BCBS
institution
Provider Business Practice Location Address Details
Address
6555 Chester Ave Ste 1
City
State
Zip
32217-2279
Phone Number
904-309-6504
Fax Number
904-503-3577
person
Provider Business Mailing Address Details
Address
6555 Chester Ave Ste 1
City
State
Zip
32217-2279
Phone Number
904-309-6504
Fax Number
904-503-3577
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA9106827 (Florida)
Definition
Definition to come...
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