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General NPI Number Information
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NPI Number | 1174892921
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Entity Type | Organization
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Legal Business Name | JADE PALMS HEALTH & HEALING CENTER, PA
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Dates
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Enumeration Date | 12/23/2011
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 1413 S PATRICK DR STE 4
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City | INDIAN HARBOUR BEACH
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State | FL
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Zip | 32937-4373
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Country | US
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Telephone | 321-960-6959
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Fax | 321-622-8919
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Provider Business Mailing Address
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Address Line | 1413 S PATRICK DR STE 4
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City | INDIAN HARBOUR BEACH
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State | FL
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Zip | 32937-4373
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Country | US
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Telephone | 321-960-6959
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Fax | 321-622-8919
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | MS. JENNIFER LYN NAFE
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Credential | AP
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Telephone | 321-960-6959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP1638
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License Number State | FL
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