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General NPI Number Information
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NPI Number | 1205215043
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Entity Type | Individual
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Provider Name | JENNIFER PAUL APRN
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Gender | Female
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 6320 MIRAMAR PKWY STE H
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City | MIRAMAR
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State | FL
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Zip | 33023-3999
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Country | US
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Telephone | 754-204-2704
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Fax | 754-701-7651
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Provider Business Mailing Address
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Address Line | 3600 S STATE ROAD 7 STE 370
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City | MIRAMAR
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State | FL
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Zip | 33023-7204
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Country | US
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Telephone | 754-204-2704
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11012734
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9406460
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License Number State | FL
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