MEDICARE: JEANYN INC

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
1	163W00000X	Registered Nurse	ARNP9234017	FL

General Provider Information

NPI Number	:	1801255930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEANYN INC

Provider Business Mailing Address
First Line	:	1898 SW 27TH AVE
Second Line	:	SUITE 1
City	:	MIAMI
State	:	FL
Zip	:	33145-2445
Country	:	US
Telephone Number	:	305-447-8777
Fax Number	:	305-447-8126

Provider Business Practice Location Address
First Line	:	1898 SW 27TH AVE
Second Line	:	SUITE 1
City	:	MIAMI
State	:	FL
Zip	:	33145-2445
Country	:	US
Telephone Number	:	305-447-8777
Fax Number	:	305-447-8126

Authorized Official
Title or Position	:	OWNER
Name	:	NOEL M ROJO
Credential	:	ARNP
Telephone Number	:	305-447-8777

Provider Enumeration Date	:	02/17/2016
Last Update Date	:	02/17/2016

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