All Medicaid billing entities listing JAQUEZ, STEPHANIE (SOLE MBR) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| South Carolina | 1 | $3K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | CONSULTORIO MEDICO LATINO | NORTH CHARLESTON, SC | Family Medicine Physician | $3K |