Healthcare Provider Details

I. General information

NPI: 1447477633
Provider Name (Legal Business Name): JENNIFER DAIF PARKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 09/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5258 LINTON BLVD SUITE 303
DELRAY BEACH FL
33484-6540
US

IV. Provider business mailing address

5150 LINTON BLVD SUITE 210
DELRAY BEACH FL
33484-6543
US

V. Phone/Fax

Practice location:
  • Phone: 561-499-2015
  • Fax: 561-499-2016
Mailing address:
  • Phone: 561-499-2015
  • Fax: 561-499-2016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number242733
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME101231
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: