Individual
JENIFER HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
11260 SULLIVAN ST, RIVERVIEW, FL 33578-2140
(813) 689-7571
(813) 654-8129
Mailing address
900 S PINE ISLAND RD STE 800, PLANTATION, FL 33324-3923
(813) 689-7571
(813) 654-8129
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS15471
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100211600
—
FL
Enumeration date
03/31/2015
Last updated
01/21/2020
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