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NPI Code Detail

MEDICARE: JENNIFER THERVIL

MEDICARE:   JENNIFER  THERVIL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1376J00000XHomemaker235080FL

General Provider Information

NPI Number : 1306338132
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER THERVIL
Provider Business Mailing Address
First Line : 7417 SW 13TH ST
Second Line :
City : NORTH LAUDERDALE
State : FL
Zip : 33068-3612
Country : US
Telephone Number : 954-600-5936
Fax Number :
Provider Business Practice Location Address
First Line : 7417 SW 13TH ST
Second Line :
City : NORTH LAUDERDALE
State : FL
Zip : 33068-3612
Country : US
Telephone Number : 954-600-5936
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2018
Last Update Date : 06/06/2018

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Directions to “ JENNIFER THERVIL ” Practice Location

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