Jativa, Marcela
Jativa, Marcela is an sole proprietor health care provider with primary practice located at 1356 State Road 60 E , Lake Wales FL 33853-4322. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Jativa, Marcela can be contacted via phone (863) 679-8888.Contact Information
Primary practice address
1356 State Road 60 E
Lake Wales FL 33853-4322
Phone: (863) 679-8888
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME109816 | Florida |
Profile Details
| NPI number | 1699942821 |
|---|---|
| LBN Legal business name | Jativa, Marcela |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 16th, 2008 |
| Last updated | Oct 27th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699942821 | NPPES |
| Florida | MEDICAID | 003691200 |
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