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Individual

JOHANA F DUQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
4850 W OAKLAND PARK BLVD, 201, LAUDERDALE LAKES, FL 33313-7260
(954) 735-3535
(954) 735-7908
Mailing address
4850 W OAKLAND PARK BLVD, 201, LAUDERDALE LAKES, FL 33313-7260
(954) 735-3535
(954) 735-7908

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9105593
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009196800
FL
Enumeration date
11/29/2010
Last updated
07/20/2016
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