Individual
JUDENIE RAPHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D
Contact information
Practice address
1128 N LAURA ST, JACKSONVILLE, FL 32206-4912
(904) 344-3403
(904) 355-4149
Mailing address
1128 N LAURA ST, JACKSONVILLE, FL 32206-4912
(904) 344-3403
(904) 355-4149
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9502265
FL
163WH0200X
Home Health Registered Nurse
9502265
FL
231H00000X
Audiologist
Primary
AY1834
FL
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003154616A
—
GA
05
—
010514600
—
FL
Enumeration date
01/02/2014
Last updated
11/27/2023
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