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General NPI Number Information
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NPI Number | 1710442009
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Entity Type | Organization
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Legal Business Name | TARJ MEDICAL CENTER
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Dates
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Enumeration Date | 01/31/2019
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Last Update Date | 01/31/2019
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Provider Practice Location Address
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Address Line | 175 SOUTH SR 7
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City | MARGATE
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State | FL
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Zip | 33068
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Country | US
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Telephone | 954-586-4349
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Fax |
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Provider Business Mailing Address
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Address Line | 1440 CORAL RIDGE DR STE 287
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-5433
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ARNP
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Name | ROSENIQUE DUVERNA
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Credential | ARNP
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Telephone | 954-529-6157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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