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General NPI Number Information
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NPI Number | 1053253310
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Entity Type | Individual
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Provider Name | WOODJINA JACQUES
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Gender | Female
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 4200 NW 34TH ST APT 321
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-5773
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Country | US
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Telephone | 954-471-4573
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 NW 34TH ST APT 321
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-5773
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Country | US
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Telephone | 954-471-4573
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 33690
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License Number State | FL
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