Healthcare Provider Details

I. General information

NPI: 1689597635
Provider Name (Legal Business Name): JAHMINE V PROSPER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ISLAND BLVD, AVENTURA, FL 33160, USA
AVENTURA FL
33160
US

IV. Provider business mailing address

3000 ISLAND BLVD, AVENTURA, FL 33160, USA
AVENTURA FL
33160
US

V. Phone/Fax

Practice location:
  • Phone: 904-864-1135
  • Fax:
Mailing address:
  • Phone: 904-864-1135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9670516
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: