Individual
JIMMEVANS DRAGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2054 VISTA PKWY STE 414, WEST PALM BEACH, FL 33411-6741
(863) 513-5069
(863) 513-5069
Mailing address
3451 COMMODORE CT, WEST PALM BEACH, FL 33411-6483
(863) 513-5069
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5200970
FL
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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