Basic Information
| Provider Information | |||||||||
| NPI: | 1922670785 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BINI | ||||||||
| FirstName: | JENNYFER | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 198054 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303848054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7865962000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1228 S PINE ISLAND RD STE 410 | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333244583 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548371490 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2021 | ||||||||
| LastUpdateDate: | 08/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APRN11014244 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.