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Individual

JENNIFER CORONA TEITELBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2828 SE TATE AVE, PORT ST LUCIE, FL 34984-8939
(203) 545-2371
Mailing address
2828 SE TATE AVE, PORT ST LUCIE, FL 34984-8939
(203) 545-2371

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
11015909
FL
363LA2200X
Adult Health Nurse Practitioner
11015909
FL
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
11015909
FL
363LC1500X
Community Health Nurse Practitioner
11015909
FL
363LG0600X
Gerontology Nurse Practitioner
11015909
FL

Other

Enumeration date
11/03/2021
Last updated
11/03/2021
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