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Individual

DR. JACQUELINE STEPHANIE DE LA CRUZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9109 S US HIGHWAY 1 STE 101, PORT ST LUCIE, FL 34952-3453
(772) 398-1305
(772) 398-1307
Mailing address
2910 NW TREVISO CIR, PORT SAINT LUCIE, FL 34986-6308

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ACN1719
FL

Other

Enumeration date
11/08/2024
Last updated
04/23/2025
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