Healthcare Provider Details

I. General information

NPI: 1902904204
Provider Name (Legal Business Name): HELENA GEMAYEL AZZI A.R.N.P/
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4495 MILITARY TRL SUITE 202
JUPITER FL
33458-4839
US

IV. Provider business mailing address

4495 MILITARY TRL SUITE 202
JUPITER FL
33458-4839
US

V. Phone/Fax

Practice location:
  • Phone: 561-627-6277
  • Fax: 561-626-6277
Mailing address:
  • Phone: 561-627-6277
  • Fax: 561-627-6277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP2508082
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: