Healthcare Provider Details

I. General information

NPI: 1497633101
Provider Name (Legal Business Name): JENNIFER DE HOMBRE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5410 NW 33RD AVE STE 107
FT LAUDERDALE FL
33309-0004
US

IV. Provider business mailing address

5410 NW 33RD AVE STE 107
FT LAUDERDALE FL
33309-0004
US

V. Phone/Fax

Practice location:
  • Phone: 833-602-3336
  • Fax:
Mailing address:
  • Phone: 305-989-8353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS39727
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: