Healthcare Provider Details

I. General information

NPI: 1053658617
Provider Name (Legal Business Name): JESSICA ANNE HENRY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2013
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FLORIDA KEYS PEDIATRIC AND ADOLESCENT CENTER 91550 OVERSEAS HWY STE 209
TAVERNIER FL
33070-2513
US

IV. Provider business mailing address

233 S BAY HARBOR DR
KEY LARGO FL
33037-2006
US

V. Phone/Fax

Practice location:
  • Phone: 305-853-0558
  • Fax: 305-853-0584
Mailing address:
  • Phone: 305-393-1506
  • Fax: 305-701-4373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9246608
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number202114821NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: