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NPI Code Detail

MEDICARE: JORGE JARQUIN CSA

MEDICARE:   JORGE  JARQUIN  CSA
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
1246ZC0007XSurgical Assistant

General Provider Information

NPI Number : 1508216284
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE JARQUIN CSA
Provider Business Mailing Address
First Line : 1995 E OAKLAND PARK BLVD
Second Line : SUITE 250
City : FORT LAUDERDALE
State : FL
Zip : 33306-1147
Country : US
Telephone Number : 954-791-6146
Fax Number : 954-337-2733
Provider Business Practice Location Address
First Line : 1995 E OAKLAND PARK BLVD
Second Line : SUITE 250
City : FORT LAUDERDALE
State : FL
Zip : 33306-1147
Country : US
Telephone Number : 954-791-6146
Fax Number : 954-337-2733
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2016
Last Update Date : 06/14/2016

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Directions to “ JORGE JARQUIN CSA” Practice Location

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