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General NPI Number Information
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NPI Number | 1730572280
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Entity Type | Individual
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Provider Name | JODI-ANN JEAN-VERTUS BA
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Gender | Female
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 03/09/2015
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Provider Practice Location Address
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Address Line | 5749 WESTGATE DR SUITE 102
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City | ORLANDO
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State | FL
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Zip | 32835-5040
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Country | US
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Telephone | 321-441-1030
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Fax | 866-936-8124
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Provider Business Mailing Address
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Address Line | 2203 YANKEE PL APT. 435
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City | ORLANDO
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State | FL
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Zip | 32839-5390
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Country | US
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Telephone | 561-574-7246
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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