Provider Demographics
NPI:1699211227
Name:TINEO, JANNET (BA)
Entity Type:Individual
Prefix:
First Name:JANNET
Middle Name:
Last Name:TINEO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 VIRGINIAN DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-2926
Mailing Address - Country:US
Mailing Address - Phone:407-271-6856
Mailing Address - Fax:
Practice Address - Street 1:4965 N PALM AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9110
Practice Address - Country:US
Practice Address - Phone:321-228-3765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator