Individual
JENNIFER DIAZ ROQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1326 CALLE SALUD APT 1010, PONCE, PR 00717-1691
(813) 638-3594
Mailing address
PO BOX 7004, PONCE, PR 00732-7004
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
PR
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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