Provider Demographics
NPI:1548716327
Name:JASMINE NOEL
Entity type:Organization
Organization Name:JASMINE NOEL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-913-8605
Mailing Address - Street 1:1600 S FEDERAL HWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062
Mailing Address - Country:US
Mailing Address - Phone:954-913-8605
Mailing Address - Fax:
Practice Address - Street 1:1600 S FEDERAL HWY
Practice Address - Street 2:SUITE 205
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062
Practice Address - Country:US
Practice Address - Phone:954-532-6655
Practice Address - Fax:954-532-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL624181251E00000X
FL696415253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL624181Medicaid