Provider Demographics
NPI:1689346132
Name:BAROCAS, JESSICA KATHLEEN (ARNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:KATHLEEN
Last Name:BAROCAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:KATHLEEN
Other - Last Name:CAUDILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7010 NW 49TH PL
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-3436
Mailing Address - Country:US
Mailing Address - Phone:502-649-1032
Mailing Address - Fax:
Practice Address - Street 1:7010 NW 49TH PL
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-3436
Practice Address - Country:US
Practice Address - Phone:502-649-1032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11015705363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner