Provider Demographics
NPI:1841643731
Name:GOLLETTI, JENNI LYNN (FNP-BC)
Entity type:Individual
Prefix:
First Name:JENNI
Middle Name:LYNN
Last Name:GOLLETTI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10095 N KENDALL DR STE 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1797
Mailing Address - Country:US
Mailing Address - Phone:305-595-5455
Mailing Address - Fax:
Practice Address - Street 1:10095 N KENDALL DR STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1797
Practice Address - Country:US
Practice Address - Phone:305-595-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9465498363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily