Individual
ANTHONY MARK LAQUIDARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
2001 KINGSLEY AVE, ORANGE PARK, FL 32073-5148
(912) 247-2499
Mailing address
5075 ORTEGA COVE CIR, JACKSONVILLE, FL 32244-3202
(904) 349-0078
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN11008161
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11008161
FL
Other
Enumeration date
07/17/2020
Last updated
06/24/2024
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