Organization
JCE FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN GUILLERMO COQUELET D.O. (PRESIDENT)
(772) 466-8884
Entity
Organization
Contact information
Practice address
4640 S 25TH ST, FORT PIERCE, FL 34981-5057
(772) 466-8884
(772) 466-8832
Mailing address
PO BOX 13450, FORT PIERCE, FL 34979-3450
(772) 466-8884
(772) 466-8832
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
OS6690
FL
Other
Enumeration date
10/09/2013
Last updated
12/17/2013
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