Provider Demographics
NPI:1992459937
Name:KIRLANGITIS, JENNIFER KAY
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAY
Last Name:KIRLANGITIS
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 1:901 VENETIA BAY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-8046
Mailing Address - Country:US
Mailing Address - Phone:941-497-5511
Mailing Address - Fax:941-492-2221
Practice Address - Street 1:901 VENETIA BAY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-8046
Practice Address - Country:US
Practice Address - Phone:941-497-5511
Practice Address - Fax:941-492-2221
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1851782363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care