Provider Demographics
NPI:1710061726
Name:JETTE-ARCAND, JOSEE (MD)
Entity Type:Individual
Prefix:MRS
First Name:JOSEE
Middle Name:
Last Name:JETTE-ARCAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:JOSEE
Other - Middle Name:
Other - Last Name:ARCAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8055 SPYGLASS HILL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8564
Mailing Address - Country:US
Mailing Address - Phone:321-255-7334
Mailing Address - Fax:321-255-7336
Practice Address - Street 1:8055 SPYGLASS HILL RD STE 103
Practice Address - Street 2:
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940
Practice Address - Country:US
Practice Address - Phone:321-255-7334
Practice Address - Fax:321-255-7336
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87115207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH98368Medicare UPIN