Healthcare Provider Details

I. General information

NPI: 1730965765
Provider Name (Legal Business Name): JHENELLE YEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3335 N UNIVERSITY DR STE 5
HOLLYWOOD FL
33024-2200
US

IV. Provider business mailing address

3199 FOXCROFT RD APT 207
MIRAMAR FL
33025-4174
US

V. Phone/Fax

Practice location:
  • Phone: 954-442-9422
  • Fax:
Mailing address:
  • Phone: 954-801-5770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI6214
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: