Provider Demographics
NPI:1932505500
Name:PLUVIOSE, JUMEL
Entity Type:Individual
Prefix:
First Name:JUMEL
Middle Name:
Last Name:PLUVIOSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14322 NW 14TH CT
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2905
Mailing Address - Country:US
Mailing Address - Phone:954-643-5979
Mailing Address - Fax:
Practice Address - Street 1:14322 NW 14TH CT
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2905
Practice Address - Country:US
Practice Address - Phone:954-643-5979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility