Provider Demographics
NPI:1851653331
Name:JEAN, MANIELA EDOUARD (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MANIELA
Middle Name:EDOUARD
Last Name:JEAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16451 NE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3675
Mailing Address - Country:US
Mailing Address - Phone:305-949-5499
Mailing Address - Fax:305-949-5461
Practice Address - Street 1:16451 NE 6TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3675
Practice Address - Country:US
Practice Address - Phone:305-949-5499
Practice Address - Fax:305-949-5461
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2212292363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily