Provider Demographics
NPI:1851572747
Name:MAGUA, JESSENIA (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSENIA
Middle Name:
Last Name:MAGUA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8880 ROYAL PALM BOULEVARD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-753-2411
Mailing Address - Fax:954-753-1176
Practice Address - Street 1:8880 ROYAL PALM BOULEVARD
Practice Address - Street 2:SUITE 100
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-753-2411
Practice Address - Fax:954-753-1176
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2021-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME109091207VX0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics