Healthcare Provider Details

I. General information

NPI: 1477064327
Provider Name (Legal Business Name): YVETTE JEUDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 10/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12461 SW 1ST CT
PLANTATION FL
33325-2701
US

IV. Provider business mailing address

12461 SW 1ST CT
PLANTATION FL
33325-2701
US

V. Phone/Fax

Practice location:
  • Phone: 754-707-9109
  • Fax:
Mailing address:
  • Phone: 754-707-9109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: