Provider Demographics
NPI:1730821190
Name:ALFORD, JEANETTE BREWER
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:BREWER
Last Name:ALFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11614 HOWEY CROSS RD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34715-9070
Mailing Address - Country:US
Mailing Address - Phone:321-361-8374
Mailing Address - Fax:
Practice Address - Street 1:11614 HOWEY CROSS RD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34715-9070
Practice Address - Country:US
Practice Address - Phone:321-361-8374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty