Provider Demographics
NPI:1932966900
Name:JADOTTE, LOURDJINE C
Entity type:Individual
Prefix:
First Name:LOURDJINE
Middle Name:C
Last Name:JADOTTE
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 1:10326 VENITIA REAL AVE APT 209
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-4031
Mailing Address - Country:US
Mailing Address - Phone:800-515-9509
Mailing Address - Fax:
Practice Address - Street 1:10326 VENITIA REAL AVE APT 209
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-4031
Practice Address - Country:US
Practice Address - Phone:800-515-9509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)