Duque, Johana F

Duque, Johana F is an individual health care provider with primary practice located at 4850 W Oakland Park Blvd 201, Lauderdale Lakes FL 33313-7260. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Duque, Johana F can be contacted via phone (954) 735-3535.

Contact Information

Primary practice address
4850 W Oakland Park Blvd 201 Lauderdale Lakes FL 33313-7260
Phone: (954) 735-3535
Fax: (954) 735-7908
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9105593 Florida

Profile Details

NPI number 1497057350
LBN Legal business name Duque, Johana F
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2010
Last updated Jul 20th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497057350 NPPES
Florida MEDICAID 009196800

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