Provider Demographics
NPI:1174387419
Name:GONZALEZ, JESSICA FARRSHA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:FARRSHA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2606 BERMUDA LAKE DR APT 303B
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-2280
Mailing Address - Country:US
Mailing Address - Phone:719-761-7944
Mailing Address - Fax:
Practice Address - Street 1:2606 BERMUDA LAKE DR APT 303B
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-2280
Practice Address - Country:US
Practice Address - Phone:719-761-7944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant