Individual
MRS. JORDAN KIMBERLY DESRUISSEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
809 E MARION AVE, PUNTA GORDA, FL 33950-3819
(941) 639-3131
(941) 637-2579
Mailing address
809 E MARION AVE, PUNTA GORDA, FL 33950-3819
(941) 637-2529
(941) 637-2579
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106527
FL
Other
Enumeration date
04/20/2012
Last updated
01/28/2014
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