Individual
MR. JACARI TREMAINE ARCHIE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16611 GOOSE RIBBON PL, WIMAUMA, FL 33598-2363
(813) 362-1698
Mailing address
16611 GOOSE RIBBON PL, WIMAUMA, FL 33598-2363
(813) 362-1698
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
A620438813340
FL
Other
Enumeration date
03/20/2025
Last updated
03/20/2025
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