Provider Demographics
NPI:1740804178
Name:JARDIN DEDEN, INC
Entity Type:Organization
Organization Name:JARDIN DEDEN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AURELIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DORICENT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:754-252-6690
Mailing Address - Street 1:11830 NW 25TH STREET
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33323-1702
Mailing Address - Country:US
Mailing Address - Phone:754-252-6690
Mailing Address - Fax:800-574-5053
Practice Address - Street 1:11830 NW 25TH STREET
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33323-1702
Practice Address - Country:US
Practice Address - Phone:754-252-6690
Practice Address - Fax:800-574-5053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care