Provider Demographics
NPI:1760837959
Name:JASMIN, MYRTHA
Entity Type:Individual
Prefix:
First Name:MYRTHA
Middle Name:
Last Name:JASMIN
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 1:7444 COVINA CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-6053
Mailing Address - Country:US
Mailing Address - Phone:904-962-0596
Mailing Address - Fax:
Practice Address - Street 1:7444 COVINA CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-6053
Practice Address - Country:US
Practice Address - Phone:904-962-0596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide