Individual
LEONEL JEANTILUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10650 W STATE ROAD 84, DAVIE, FL 33324-4235
(954) 634-3636
Mailing address
4500 NW 36TH ST APT 301, LAUDERDALE LAKES, FL 33319-6417
(954) 873-1469
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010384800
—
FL
Enumeration date
06/26/2014
Last updated
06/26/2014
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