Individual
JESSY MADHUKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8329 W SUNRISE BLVD, PLANTATION, FL 33322-5405
(954) 627-1617
(866) 224-5691
Mailing address
8329 W SUNRISE BLVD, PLANTATION, FL 33322-5405
(954) 627-1617
(866) 224-5691
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11000908
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F11180632
—
FL
Enumeration date
11/28/2018
Last updated
08/05/2019
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