Provider Demographics
NPI:1649707597
Name:JENNINGS, CHANDRA MILETTA (DO, MPH)
Entity type:Individual
Prefix:DR
First Name:CHANDRA
Middle Name:MILETTA
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:DO, MPH
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Mailing Address - Street 1:336 NW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33128-1616
Mailing Address - Country:US
Mailing Address - Phone:305-577-4840
Mailing Address - Fax:866-343-4726
Practice Address - Street 1:336 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33128-1616
Practice Address - Country:US
Practice Address - Phone:305-577-4840
Practice Address - Fax:866-343-4726
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO0006854207Q00000X
FLOS16569207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine