Provider Demographics
NPI:1639893829
Name:SANON, JEAN VENIEL
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:VENIEL
Last Name:SANON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 CORPORATE WAY STE 111
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2041
Mailing Address - Country:US
Mailing Address - Phone:561-707-2282
Mailing Address - Fax:
Practice Address - Street 1:5601 CORPORATE WAY STE 111
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2041
Practice Address - Country:US
Practice Address - Phone:561-707-2282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9400479163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse