MEDICARE: JENNIFER OSTROFF RICHTER PA-C

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	363A00000X	Physician Assistant	9110988	FL

General Provider Information

NPI Number	:	1770984221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER OSTROFF RICHTER PA-C

Provider Business Mailing Address
First Line	:	2901 CLINT MOORE RD # 421
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-2041
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 W PALMETTO PARK RD STE 110
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3429
Country	:	US
Telephone Number	:	561-703-1988
Fax Number	:

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

Provider Enumeration Date	:	09/15/2014
Last Update Date	:	05/05/2022

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