MEDICARE: JANET FIENEMANN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW10192	FL

General Provider Information

NPI Number	:	1538465166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET FIENEMANN

Provider Business Mailing Address
First Line	:	909 5TH AVE N
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-4515
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	909 5TH AVE N
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-4515
Country	:	US
Telephone Number	:	904-521-3622
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2011
Last Update Date	:	02/14/2011

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Directions to “ JANET FIENEMANN ” Practice Location

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