Provider Demographics
NPI:1124699244
Name:ROYALL, JENNIFER MORALES (PA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MORALES
Last Name:ROYALL
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Gender:
Credentials:PA
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Mailing Address - Street 1:2556 SW MARSHFIELD CT
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-4369
Mailing Address - Country:US
Mailing Address - Phone:201-725-0261
Mailing Address - Fax:
Practice Address - Street 1:10080 SW INNOVATION WAY STE 201
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2129
Practice Address - Country:US
Practice Address - Phone:772-288-5862
Practice Address - Fax:772-288-5874
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2025-03-18
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant