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NPI Code Detail

MEDICARE: LETICIA B JEANNERET ARNP

MEDICARE:   LETICIA B JEANNERET  ARNP
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
1208000000XPediatrics PhysicianARNP3262702FL

General Provider Information

NPI Number : 1710975388
Entity Type Code : Individual
Provider Name (Legal Business Name) : LETICIA B JEANNERET ARNP
Provider Business Mailing Address
First Line : 4620 N STATE ROAD 7
Second Line : STE 316
City : LAUDERDALE LAKES
State : FL
Zip : 33319-5884
Country : US
Telephone Number : 954-967-6400
Fax Number : 954-967-6410
Provider Business Practice Location Address
First Line : 3126 N FEDERAL HWY
Second Line :
City : LIGHTHOUSE POINT
State : FL
Zip : 33064-6738
Country : US
Telephone Number : 954-941-3255
Fax Number : 954-941-7797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2005
Last Update Date : 07/08/2007

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Directions to “ LETICIA B JEANNERET ARNP” Practice Location

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