Healthcare Provider Details

I. General information

NPI: 1073269411
Provider Name (Legal Business Name): JENNIFER SARAI LOBO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER LOBO NP

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 SW 20TH ST
MIAMI FL
33145-2840
US

IV. Provider business mailing address

1624 SW 20TH ST
MIAMI FL
33145-2840
US

V. Phone/Fax

Practice location:
  • Phone: 305-300-0592
  • Fax:
Mailing address:
  • Phone: 305-300-0592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1195126
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024194897
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4704418839
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11018311
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: