Provider Demographics
NPI:1851159024
Name:PARTIN, JONATHAN S (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:S
Last Name:PARTIN
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9243 SW 172ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-2954
Mailing Address - Country:US
Mailing Address - Phone:305-479-6075
Mailing Address - Fax:
Practice Address - Street 1:9243 SW 172ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-2954
Practice Address - Country:US
Practice Address - Phone:305-479-6075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL110315552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry