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General NPI Number Information
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NPI Number | 1831364207
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Entity Type | Organization
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Legal Business Name | ALVARO J JARQUIN MD PA
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 205 N SCENIC HWY #300
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City | FROSTPROOF
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State | FL
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Zip | 33843
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Country | US
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Telephone | 863-635-4100
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Fax | 863-635-4499
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Provider Business Mailing Address
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Address Line | 205-A N SCENIC HWY #300
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City | FROSTPROOF
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State | FL
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Zip | 33843
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Country | US
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Telephone | 863-635-4100
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Fax | 863-635-4499
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KIM MANCILLAS
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Credential |
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Telephone | 863-635-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME78476
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License Number State | FL
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