Provider Demographics
NPI:1093410706
Name:SAINT HUBERT, JEANNINEDA
Entity Type:Individual
Prefix:
First Name:JEANNINEDA
Middle Name:
Last Name:SAINT HUBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-4523
Mailing Address - Country:US
Mailing Address - Phone:321-593-9032
Mailing Address - Fax:
Practice Address - Street 1:7778 SW JACK JAMES DR
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-7249
Practice Address - Country:US
Practice Address - Phone:561-377-0009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician