Healthcare Provider Details

I. General information

NPI: 1972927234
Provider Name (Legal Business Name): CLAIRE A JEANTY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E HILLSBORO BLVD 207
DEERFIELD BEACH FL
33441-4355
US

IV. Provider business mailing address

104 NW 9TH TER APT 306
HALLANDALE BEACH FL
33009-3951
US

V. Phone/Fax

Practice location:
  • Phone: 954-428-2480
  • Fax: 954-428-2904
Mailing address:
  • Phone: 305-467-5476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9347139
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: