Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 9112785 | FL |
NPI | 1154954287 |
---|---|
Provider Name | Patrick Jouissance |
First Address | Weston, FL 33326-1330 |
Second Address | Belle Glade, FL 33430-2644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2020 |
Last Update Date | 19/04/2021 |