Healthcare Provider Details

I. General information

NPI: 1760212997
Provider Name (Legal Business Name): JENNIFER G BARNES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4139 NW 88TH AVE APT 201
CORAL SPRINGS FL
33065-1856
US

IV. Provider business mailing address

4139 NW 88TH AVE APT 201
CORAL SPRINGS FL
33065-1856
US

V. Phone/Fax

Practice location:
  • Phone: 754-551-1305
  • Fax:
Mailing address:
  • Phone: 754-551-1305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: