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NPI Code Detail

MEDICARE: ALVARO JOSE JARQUIN M.D.

MEDICARE: ALVARO JOSE JARQUIN M.D.
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
1207Q00000XFamily Medicine PhysicianME78476FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275538894
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALVARO JOSE JARQUIN M.D.
Provider Business Mailing Address
First Line : 4404 S FLORIDA AVE
Second Line : SUITE 11
City : LAKELAND
State : FL
Zip : 33813-2169
Country : US
Telephone Number : 863-937-9148
Fax Number : 863-937-9653
Provider Business Practice Location Address
First Line : 4404 S FLORIDA AVE
Second Line : SUITE 11
City : LAKELAND
State : FL
Zip : 33813-2169
Country : US
Telephone Number : 863-937-9148
Fax Number : 863-937-9653
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 11/18/2013

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