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General NPI Number Information
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NPI Number | 1871161075
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Entity Type | Individual
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Provider Name | JAHNEL HAWTHORNE ARNP
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Gender | Female
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Dates
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Enumeration Date | 06/14/2021
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Last Update Date | 06/14/2021
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Provider Practice Location Address
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Address Line | 700 W HILLSBORO BLVD STE 203
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-1612
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Country | US
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Telephone | 561-309-7746
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Fax | 954-843-7313
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Provider Business Mailing Address
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Address Line | 4205 LONG KEY LN APT 1523
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City | WINTER PARK
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State | FL
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Zip | 32792-6935
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Country | US
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Telephone | 561-843-0644
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 11013146
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License Number State | FL
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