Provider Demographics
NPI:1639645500
Name:JATTIN, FARID DE JESUS (ARNP)
Entity Type:Individual
Prefix:MR
First Name:FARID
Middle Name:DE JESUS
Last Name:JATTIN
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 1:467 SW 90TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2343
Mailing Address - Country:US
Mailing Address - Phone:786-525-8397
Mailing Address - Fax:
Practice Address - Street 1:11731 MILLS DR STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4846
Practice Address - Country:US
Practice Address - Phone:305-420-2868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9252426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily