Provider Demographics
NPI:1730572280
Name:JEAN-VERTUS, JODI-ANN (BA)
Entity type:Individual
Prefix:
First Name:JODI-ANN
Middle Name:
Last Name:JEAN-VERTUS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 YANKEE PL
Mailing Address - Street 2:APT. 435
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-5390
Mailing Address - Country:US
Mailing Address - Phone:561-574-7246
Mailing Address - Fax:
Practice Address - Street 1:5749 WESTGATE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5040
Practice Address - Country:US
Practice Address - Phone:321-441-1030
Practice Address - Fax:866-936-8124
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator