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General NPI Number Information
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NPI Number | 1780303420
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Entity Type | Individual
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Provider Name | JENIFAR PATEL
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Gender | Female
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 1919 E HIGHWAY 50 STE 204
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City | CLERMONT
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State | FL
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Zip | 34711-1975
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Country | US
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Telephone | 352-717-3770
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Fax | 352-717-3771
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Provider Business Mailing Address
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Address Line | 10 LATTA CT
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2665
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Country | US
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Telephone |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9116179
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9116179
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License Number State | FL
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