Healthcare Provider Details

I. General information

NPI: 1326511569
Provider Name (Legal Business Name): JONI ANNETTE SANDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8645 N MILITARY TRL STE 508
WEST PALM BEACH FL
33410-6296
US

IV. Provider business mailing address

8645 N MILITARY TRL STE 508
WEST PALM BEACH FL
33410-6296
US

V. Phone/Fax

Practice location:
  • Phone: 561-630-8001
  • Fax: 561-630-8007
Mailing address:
  • Phone: 561-630-8001
  • Fax: 561-630-8007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number11000696
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number22441
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN11000696
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: