Individual provider · Type 1 NPI
Phadeige Etienne
Medical Physician Assistant · Mount Dora, FL
NPI number
1780568840
Active
Practice location
6163 Claystone Way
Mount Dora, FL 32757-8082
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PACN83 (FL) |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Mount Dora
About NPI 1780568840
Phadeige Etienne's National Provider Identifier is 1780568840, issued on Aug 2, 2025. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Mount Dora, FL. The record was last updated on Aug 2, 2025.