Individual
ELVIRE JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4105 PEMBROKE RD, HOLLYWOOD, FL 33021-8103
(954) 265-3015
Mailing address
2900 CORPORATE WAY, DOOR D, MIRAMAR, FL 33025-3925
(954) 276-5685
(954) 985-7074
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
ME84551
FL
207VM0101X
Maternal & Fetal Medicine Physician
Primary
ME84551
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111183200
—
FL
Enumeration date
07/27/2006
Last updated
11/03/2022
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