Provider Demographics
NPI:1295724854
Name:FRONRATH, JESSICA (ARNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:FRONRATH
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 1:900 S PINE ISLAND RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3920
Mailing Address - Country:US
Mailing Address - Phone:954-967-6400
Mailing Address - Fax:954-967-6410
Practice Address - Street 1:1017 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-5117
Practice Address - Country:US
Practice Address - Phone:561-798-9417
Practice Address - Fax:561-798-9419
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3172692363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304223500Medicaid