Provider Demographics
NPI:1033593322
Name:VINALON, JENNIFER PARDEE (APRN)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:PARDEE
Last Name:VINALON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:PARDEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14105 MCCORMICK DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-3019
Mailing Address - Country:US
Mailing Address - Phone:727-601-4513
Mailing Address - Fax:
Practice Address - Street 1:14105 MCCORMICK DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-3019
Practice Address - Country:US
Practice Address - Phone:727-601-4513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10662363LF0000X
FLARNP9311174363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily