Individual
ROGER CHARLES DAVID JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.R.N.P.
Contact information
Practice address
950NE182ND TER, NORTH MIAMI BEACH, FL 33162-1163
(347) 483-9435
Mailing address
308 NW 5TH AVE, OKEECHOBEE, FL 34972-2568
(863) 261-8354
(786) 221-4107
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
9358447
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9358447
FL
Other
Enumeration date
10/29/2014
Last updated
11/30/2023
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