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General NPI Number Information
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NPI Number | 1699509091
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Entity Type | Individual
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Provider Name | JOVANY SOMMERVILLE
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Gender | Female
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Dates
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Enumeration Date | 08/28/2024
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 5425 BEAUMONT CENTER BLVD
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City | TAMPA
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State | FL
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Zip | 33634-5261
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Country | US
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Telephone | 888-754-0398
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Fax |
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Provider Business Mailing Address
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Address Line | 15512 COLT CREEK PL
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-0256
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Country | US
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Telephone | 862-230-2136
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 431307
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | FL
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