Provider Demographics
NPI:1053958991
Name:FRANCOIS, OCTALINA (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:OCTALINA
Middle Name:
Last Name:FRANCOIS
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:OCTALINA
Other - Middle Name:
Other - Last Name:FRANCOIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICIAN ASSISTANT
Mailing Address - Street 1:3606 E BASELINE RD UNIT 123
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-9606
Mailing Address - Country:US
Mailing Address - Phone:561-809-1048
Mailing Address - Fax:
Practice Address - Street 1:3606 E BASELINE RD UNIT 123
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-9606
Practice Address - Country:US
Practice Address - Phone:561-809-1048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000423-P.A363A00000X
AZ8231363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant