Provider Demographics
NPI:1659675528
Name:FARRONE, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:FARRONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9185 BRYDEN CT
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6479
Mailing Address - Country:US
Mailing Address - Phone:561-308-9557
Mailing Address - Fax:561-461-6180
Practice Address - Street 1:1043 S STATE ROAD 7 STE 121
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6135
Practice Address - Country:US
Practice Address - Phone:561-658-1504
Practice Address - Fax:561-461-6180
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004527363LF0000X
FLAPRN9411447363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily