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General NPI Number Information
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NPI Number | 1790430569
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Entity Type | Individual
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Provider Name | JESENIA ANTOINE
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Gender | Female
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Dates
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Enumeration Date | 02/19/2022
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Last Update Date | 02/19/2022
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Provider Practice Location Address
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Address Line | 335 LARGO CAY CT APT 203
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City | OCOEE
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State | FL
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Zip | 34761-4825
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Country | US
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Telephone | 321-326-4849
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Fax | 631-327-7191
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Provider Business Mailing Address
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Address Line | 335 LARGO CAY CT APT 203
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City | OCOEE
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State | FL
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Zip | 34761-4825
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Country | US
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Telephone | 321-326-4849
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Fax | 631-327-7191
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 4617
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | L21000489589
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License Number State | FL
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