Healthcare Provider Details
I. General information
NPI: 1164332391
Provider Name (Legal Business Name): MRS. ASMANDY JEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7890 PETERS RD STE G107
PLANTATION FL
33324-4028
US
IV. Provider business mailing address
5379 LYONS RD # 844
COCONUT CREEK FL
33073-2810
US
V. Phone/Fax
- Phone: 954-526-6678
- Fax:
- Phone: 954-800-3260
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | MT5578 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: