Provider Demographics
NPI:1295471217
Name:EMILE, JEAN F (ARNP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:F
Last Name:EMILE
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 N LAUREL DR APT 2A
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5316
Mailing Address - Country:US
Mailing Address - Phone:954-326-7244
Mailing Address - Fax:
Practice Address - Street 1:3700 WASHINGTON ST STE 500B
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8259
Practice Address - Country:US
Practice Address - Phone:954-967-6110
Practice Address - Fax:954-967-6111
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11019624363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty