Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME85296 | FL |
Y | 208600000X | Surgeon | ME85296 | FL |
NPI | 1013024066 |
---|---|
Provider Name | Dr. Colleen Ellen Jakey |
First Address | Bay Pines, FL 33744-5005 |
Second Address | Bay Pines, FL 33744-5005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 02/02/2009 |