Individual
MR. JOSE ELMO BACCAY ECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
3505 NW 84TH AVE, SUNRISE, FL 33351-6607
(954) 748-3039
Mailing address
3505 NW 84TH AVE, SUNRISE, FL 33351-6607
(954) 748-3039
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
ARNP3110802
FL
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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