Iannarelli, Jennifer Myles

Iannarelli, Jennifer Myles is an individual health care provider with primary practice located at 1400 Hand Ave Ste N , Ormond Beach FL 32174-8196. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Iannarelli, Jennifer Myles can be contacted via phone (386) 872-3111.

Contact Information

Primary practice address
1400 Hand Ave Ste N Ormond Beach FL 32174-8196
Phone: (386) 872-3111
Fax: (386) 872-3190
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC3926 Florida

Profile Details

NPI number 1902879554
LBN Legal business name Iannarelli, Jennifer Myles
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Sep 28th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902879554 NPPES
Florida MEDICAID 620993900

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