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General NPI Number Information
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NPI Number | 1437421179
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Entity Type | Individual
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Provider Name | JENNY VANESSA PACKARD
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Gender | Female
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 01/26/2012
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Provider Practice Location Address
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Address Line | 7941 NW 2ND ST
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City | MIAMI
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State | FL
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Zip | 33126-8000
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Country | US
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Telephone | 305-263-6363
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Fax | 305-263-6323
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Provider Business Mailing Address
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Address Line | 7941 NW 2ND ST
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City | MIAMI
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State | FL
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Zip | 33126-8000
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Country | US
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Telephone | 305-263-6363
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Fax | 305-263-6323
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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 | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 9178
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License Number State | FL
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