Facundus, Jack

Facundus, Jack is an sole proprietor health care provider with primary practice located at 651 W Warren Ave Ste 100 , Longwood FL 32750-4036. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Facundus, Jack can be contacted via phone (321) 999-9617.

Contact Information

Primary practice address
651 W Warren Ave Ste 100 Longwood FL 32750-4036
Phone: (321) 999-9617
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP2824142 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 090740-23 New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN2824142 Florida

Profile Details

NPI number 1376092809
LBN Legal business name Facundus, Jack
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 26th, 2016
Last updated Jun 14th, 2024 - about 6 months 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 1376092809 NPPES
Florida Other F0416038 AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION PROGRAM
Florida Other ARNP2824142 AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION PROGRAM

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