Provider Demographics
NPI:1275801383
Name:JAZMIN AWAN PA
Entity Type:Organization
Organization Name:JAZMIN AWAN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAZMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR
Authorized Official - Phone:954-543-3603
Mailing Address - Street 1:20581 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5026
Mailing Address - Country:US
Mailing Address - Phone:954-543-3603
Mailing Address - Fax:
Practice Address - Street 1:20581 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-5026
Practice Address - Country:US
Practice Address - Phone:954-543-3603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health