Healthcare Provider Details

I. General information

NPI: 1538525597
Provider Name (Legal Business Name): JACINTH S HENTON-O'CONNOR ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2016
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10115 FOREST HILL BLVD STE 200
WELLINGTON FL
33414-3104
US

IV. Provider business mailing address

7593 W BOYNTON BEACH BLVD
BOYNTON BEACH FL
33437-6154
US

V. Phone/Fax

Practice location:
  • Phone: 561-795-0016
  • Fax: 561-472-2300
Mailing address:
  • Phone: 561-678-2652
  • Fax: 888-316-2198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9245769
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: