Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN11011682 | FL |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN11011682 | FL |
NPI | 1548848948 |
---|---|
Provider Name | Jacqueline Rosales Javate |
First Address | Kissimmee, FL 34744-9269 |
Second Address | Orlando, FL 32803-1248 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2021 |
Last Update Date | 09/06/2021 |