Provider Demographics
NPI:1659777175
Name:VERME, JACQUELYN SUZANNE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELYN
Middle Name:SUZANNE
Last Name:VERME
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JACQUELYN
Other - Middle Name:
Other - Last Name:SASTRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3100 SW 62ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3009
Mailing Address - Country:US
Mailing Address - Phone:786-624-3394
Mailing Address - Fax:786-624-3395
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:786-624-3394
Practice Address - Fax:786-624-3395
Is Sole Proprietor?:No
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9220399363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics