Individual
JEANAN FARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7700 NW 48TH AVE, COCONUT CREEK, FL 33073-3508
(954) 655-5268
Mailing address
7700 NW 48TH AVE, COCONUT CREEK, FL 33073-3508
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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