Provider Demographics
NPI:1992416796
Name:JINNAH, NADIA J
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:J
Last Name:JINNAH
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 1:351 S CYPRESS RD STE 210K
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-7177
Mailing Address - Country:US
Mailing Address - Phone:954-303-6375
Mailing Address - Fax:
Practice Address - Street 1:351 S CYPRESS RD STE 210K
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-7177
Practice Address - Country:US
Practice Address - Phone:954-303-6375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies