=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295471217
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JEAN F EMILE ARNP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2022
-----------------------------------------------------
Last Update Date | 03/04/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3700 WASHINGTON ST STE 500B
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33021-8259
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-967-6110
-----------------------------------------------------
Fax | 954-967-6111
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 480 N LAUREL DR APT 2A
-----------------------------------------------------
City | MARGATE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33063-5316
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-326-7244
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 11019624
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------