Provider Demographics
NPI:1275647786
Name:VANOVER, JANINA ELISBETH (LMT)
Entity Type:Individual
Prefix:MRS
First Name:JANINA
Middle Name:ELISBETH
Last Name:VANOVER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5329 NE 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIGH SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32643-5847
Mailing Address - Country:US
Mailing Address - Phone:386-454-8032
Mailing Address - Fax:
Practice Address - Street 1:5329 NE 60TH AVE
Practice Address - Street 2:
Practice Address - City:HIGH SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32643-5847
Practice Address - Country:US
Practice Address - Phone:386-454-8032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA25598174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist