Provider Demographics
NPI:1669854899
Name:JENNIFERLYN LLC
Entity Type:Organization
Organization Name:JENNIFERLYN LLC
Other - Org Name:JENNIFERLYNLLC MEDICAL MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:BEH-ZIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:561-379-6362
Mailing Address - Street 1:9346 SE PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-6226
Mailing Address - Country:US
Mailing Address - Phone:561-379-6362
Mailing Address - Fax:
Practice Address - Street 1:1080 E INDIANTOWN RD STE 204
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5188
Practice Address - Country:US
Practice Address - Phone:561-379-6362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM33321225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty