Individual
MR. JOSE LUIS ESTRADA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7856
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7632
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001175596
VA
367500000X
Certified Registered Nurse Anesthetist
0024167864
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
9331689
FL
Other
Enumeration date
02/29/2008
Last updated
10/03/2011
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