Female

Johana F. Duque PA

Medical Physician Assistant in Lauderdale Lakes, FL(View on Map)

Full Name

Johana F Duque PA

NPI Number

1497057350

NPI Type

Individual Provider

Gender

Female

Enumeration Date

11/29/2010

Specialties

(Taxonomies)

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

PA9105593

Contact
Information

Purpose

Mailing
Location

Address

4850 W OAKLAND PARK BLVD
4850 W OAKLAND PARK BLVD

City

Lauderdale Lakes
Lauderdale Lakes

State

FL
FL

Postal Code

33313-7260
33313-7260

Country

US
US

Telephone Number

(954) 735-3535
(954) 735-3535

Identifiers

Identifier

009196800

Identifier State

FL

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/20/2016

Provider Address

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