Healthcare Provider Details

I. General information

NPI: 1538431440
Provider Name (Legal Business Name): JANE PANARES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 W SAMPLE RD
CORAL SPRINGS FL
33067-5313
US

IV. Provider business mailing address

5900 W SAMPLE RD APT. 304
CORAL SPRINGS FL
33067-3248
US

V. Phone/Fax

Practice location:
  • Phone: 954-345-7040
  • Fax:
Mailing address:
  • Phone: 954-345-7040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: