MEDICARE: JENNA BARBARA FERNAMBERG

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	235Z00000X	Speech-Language Pathologist	13277	FL

General Provider Information

NPI Number	:	1598696460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA BARBARA FERNAMBERG

Provider Business Mailing Address
First Line	:	3400 PERIWINKLE CT APT 114
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2700
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5589 OKEECHOBEE BLVD STE 205
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-4486
Country	:	US
Telephone Number	:	561-376-2573
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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Directions to “ JENNA BARBARA FERNAMBERG ” Practice Location

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