Provider Demographics
NPI:1407602303
Name:IDEAL HORMONE
Entity type:Organization
Organization Name:IDEAL HORMONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-FRANCOIS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:203-954-9845
Mailing Address - Street 1:1446 WATERVIEW RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-6235
Mailing Address - Country:US
Mailing Address - Phone:203-954-9845
Mailing Address - Fax:
Practice Address - Street 1:401 N MILLS AVE STE B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5735
Practice Address - Country:US
Practice Address - Phone:407-734-2546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty