=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942112230
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CADOMED,LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/21/2026
-----------------------------------------------------
Last Update Date | 09/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 480 N LAUREL DR APT 2A
-----------------------------------------------------
City | MARGATE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33063-5316
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-326-7244
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7800 W OKLND PK BLVD STE 105
-----------------------------------------------------
City | SUNRISE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33351-1120
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-326-7244
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MGR
-----------------------------------------------------
Name | JEAN EMILE
-----------------------------------------------------
Credential | APRN
-----------------------------------------------------
Telephone | 954-326-7244
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------