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General NPI Number Information
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NPI Number | 1558866939
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Entity Type | Individual
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Provider Name | JEANIE MARIE MENENDEZ ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 880 SW 145TH AVE STE 202
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-6171
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Country | US
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Telephone | 866-849-0692
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Fax | 888-973-8821
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Provider Business Mailing Address
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Address Line | 4923 CREST HILL DR
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City | TAMPA
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State | FL
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Zip | 33615-4615
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Country | US
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Telephone | 954-232-9720
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Fax | 954-232-9720
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.0102864-C-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 314596
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4027055
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | GAA-NP003243
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704416833
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1178377
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9269734
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License Number State | FL
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