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NPI Code Detail

MEDICARE: WOODJINA JACQUES

MEDICARE: WOODJINA JACQUES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant33690FL

General Provider Information

NPI Number : 1053253310
Entity Type Code : Individual
Provider Name (Legal Business Name) : WOODJINA JACQUES
Provider Business Mailing Address
First Line : 4200 NW 34TH ST APT 321
Second Line :
City : LAUDERDALE LAKES
State : FL
Zip : 33319-5773
Country : US
Telephone Number : 954-471-4573
Fax Number :
Provider Business Practice Location Address
First Line : 4200 NW 34TH ST APT 321
Second Line :
City : LAUDERDALE LAKES
State : FL
Zip : 33319-5773
Country : US
Telephone Number : 954-471-4573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “ WOODJINA JACQUES ” Practice Location

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