Provider Demographics
NPI:1720727084
Name:JEAN EVINS REMY
Entity Type:Organization
Organization Name:JEAN EVINS REMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-231-9024
Mailing Address - Street 1:5040 SALERNO ST
Mailing Address - Street 2:
Mailing Address - City:AVE MARIA
Mailing Address - State:FL
Mailing Address - Zip Code:34142-9578
Mailing Address - Country:US
Mailing Address - Phone:239-231-9024
Mailing Address - Fax:
Practice Address - Street 1:5040 SALERNO ST
Practice Address - Street 2:
Practice Address - City:AVE MARIA
Practice Address - State:FL
Practice Address - Zip Code:34142-9578
Practice Address - Country:US
Practice Address - Phone:239-231-9024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty