Provider Demographics
NPI:1730379447
Name:KING, JEFFREY T (RN)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:T
Last Name:KING
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2990 SW 30TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-3616
Mailing Address - Country:US
Mailing Address - Phone:305-305-2532
Mailing Address - Fax:
Practice Address - Street 1:2990 SW 30TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-3616
Practice Address - Country:US
Practice Address - Phone:305-305-2532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-29
Last Update Date:2007-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2726392163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator