Provider Demographics
NPI:1013421478
Name:JADOTTE, MARJORIE CLAUDINE (ARNP)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:CLAUDINE
Last Name:JADOTTE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 SW 32ND ST
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5648
Mailing Address - Country:US
Mailing Address - Phone:954-439-4402
Mailing Address - Fax:
Practice Address - Street 1:2350 W OAKLAND PARK BLVD STE 900
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1409
Practice Address - Country:US
Practice Address - Phone:772-361-3051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2925252363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty