Individual
JEANNINE CAMILLE TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
2900 W PROSPECT RD, FT LAUDERDALE, FL 33309-2519
(954) 677-3113
(954) 497-3857
Mailing address
729 NW 47TH ST, POMPANO BEACH, FL 33064-5005
(954) 258-9300
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/04/2007
Last updated
07/08/2007
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