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NPI Code Detail

MEDICARE: JESSICA TABORDA

MEDICARE:   JESSICA  TABORDA
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
1183500000XPharmacistPS63866FL

General Provider Information

NPI Number : 1437894185
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA TABORDA
Provider Business Mailing Address
First Line : 13748 RUSHING CREEK RUN
Second Line :
City : ORLANDO
State : FL
Zip : 32824-9216
Country : US
Telephone Number : 407-883-8921
Fax Number :
Provider Business Practice Location Address
First Line : 14185 LAKE NONA BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32824-7421
Country : US
Telephone Number : 407-204-2287
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2022
Last Update Date : 04/27/2022

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Directions to “ JESSICA TABORDA ” Practice Location

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