Individual
MAYRA DEJESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
10739 DEERWOOD PARK BLVD STE 200, JACKSONVILLE, FL 32256-4839
(904) 719-7707
(800) 266-5158
Mailing address
1792 MEADOWGOLD LN, WINTER PARK, FL 32792-6364
(407) 256-3715
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
ARNP2114722
FL
364SG0600X
Gerontology Clinical Nurse Specialist
2114722
FL
Other
Enumeration date
07/11/2016
Last updated
01/26/2018
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