Provider Demographics
NPI:1174234181
Name:FAUNI, JANELLE
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:FAUNI
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 1:17346 SW 33RD CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1693
Mailing Address - Country:US
Mailing Address - Phone:954-670-9473
Mailing Address - Fax:
Practice Address - Street 1:17346 SW 33RD CT
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-1693
Practice Address - Country:US
Practice Address - Phone:954-670-9473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022937363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily