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General NPI Number Information
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NPI Number | 1740804178
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Entity Type | Organization
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Legal Business Name | JARDIN DEDEN, INC
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Dates
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Enumeration Date | 06/01/2020
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 11830 NW 25TH STREET
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City | PLANTATION
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State | FL
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Zip | 33323-1702
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Country | US
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Telephone | 754-252-6690
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Fax | 800-574-5053
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Provider Business Mailing Address
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Address Line | 11830 NW 25TH STREET
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City | PLANTATION
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State | FL
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Zip | 33323-1702
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Country | US
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Telephone | 754-252-6690
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Fax | 800-574-5053
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Authorized Official
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Title or Position | OWNER
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Name | AURELIE DORICENT
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Credential | NP
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Telephone | 754-252-6690
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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