Healthcare Provider Details

I. General information

NPI: 1427215383
Provider Name (Legal Business Name): JENNIFER JOZWIAK M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 12/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1459 RIDGE ST STE 2
NAPLES FL
34103-4211
US

IV. Provider business mailing address

1879 VETERANS PARK DRIVE STE. 1201
NAPLES FL
34109-0492
US

V. Phone/Fax

Practice location:
  • Phone: 239-262-6668
  • Fax: 239-262-0017
Mailing address:
  • Phone: 239-592-9666
  • Fax: 239-592-1835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY745
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: