JENNIFER RIDENOURE (NPI# 1912012816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912012816 |
| Entity Type | Individual |
| Full Name | JENNIFER RIDENOURE |
| Credential | P.A.C |
| Practice Address |
1330 Riverland Rd Fort Lauderdale FL 33312-2961 |
| Mailing Address |
2936 Cambridge Ln Hollywood FL 33026-3748 |
| Practice Telephone | 9543219826 |
| Practice Fax Number | 9543219660 |
| Mailing Telephone | 9547040108 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9103460 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 292299100 | 05 |
| Street Address |
1330 RIVERLAND RD |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33312-2961 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376658294 | Broward Medical Center of Davie Inc | Family Medicine | 1330 Riverland Rd, Fort Lauderdale, FL 33312-2961 | 2006-08-20 |
| 1912202797 | Vanguard Medical Group LLC | Family Medicine | 1330 Riverland Rd, Fort Lauderdale, FL 33312-2961 | 2011-01-25 |
| 1265633903 | Angela Maria Rodriguez | Family Medicine | 1330 Riverland Rd, Fort Lauderdale, FL 33312-2961 | 2007-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679112965 | Krista Moreno | Marriage & Family Therapist | 2699 Stirling Road Building C Suite 403e, Fort Lauderdale, FL 33312 | 2020-01-03 |
| 1700428026 | Caring Village of Lauderdale LLC | Assisted Living Facility | 408-412 Sw 7th Ave, Fort Lauderdale, FL 33312 | 2019-10-09 |
| 1548742356 | Inspire Acupuncture | Acupuncturist | 1000 Riverside Drive, Fort Lauderdale, FL 33312 | 2018-08-29 |
| 1447762919 | Daniel Desta Bekele | General Practice | 1001 W Las Olas Blvd Apt 4, Fort Lauderdale, FL 33312 | 2017-10-24 |
| 1649798653 | Angel Luis Perez | Nurse Practitioner | 3041 Sw 47 Street, Fort Lauderdale, FL 33312 | 2017-08-30 |
| 1902322738 | Ashley Ingrid Rini | Dentist | 1620 Sw 33rd Ave, Fort Lauderdale, FL 33312 | 2017-08-14 |
| 1548794993 | Elise Cruz | Nurse Practitioner | 3301 Sw 16th Street, Fort Lauderdale, FL 33312 | 2017-04-12 |
| 1619415924 | Antoinette Battle | Nurse Practitioner | 3470 Sw 19th Street, Fort Lauderdale, FL 33312 | 2017-02-07 |
| 1902344252 | Melissa Miller | Counselor | 2962 Southwest 26th Terrace, 204, Fort Lauderale, FL 33312 | 2017-02-07 |
| 1164975934 | Brandon Nieves Stella | Technician, Other | 620 Sw 14th Ter, Fort Lauderdale, FL 33312 | 2016-07-28 |
| Find all providers in zip 33312 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225432305 | Kaitlin Abers | Physician Assistant | 3000 Ne 57th St, Fort Lauderdale, FL 33308-2810 | 2014-10-17 |
| 1710230651 | Shelby A Lane | Physician Assistant | 3319 Ne 15th Ct, Fort Lauderdale, FL 33304-1709 | 2012-10-16 |
| 1952687741 | Michal S Goldshmid | Physician Assistant | 2774 West Davie Blvd, Riverland Medical Centers,inc., Fort Lauderdale, FL 33312 | 2011-10-25 |
| 1336447689 | Xavier Fernando Varela | Physician Assistant | 721 Se 17th Street Cswy, Fort Lauderdale, FL 33316-2983 | 2011-03-10 |
| 1972804557 | Jonathan David Gildin | Physician Assistant | 1625 E 3rd Ave, Suite 300, Fort Lauderdale, FL 33316 | 2010-11-12 |
| 1144558636 | Brigitte Shaw | Physician Assistant | 1301 E Broward Blvd Ste 240, Fort Lauderdale, FL 33301 | 2009-11-23 |
| 1720066822 | Salvador Torres-torres | Physician Assistant | 1330 Se 4th Ave Ste B, Fort Lauderdale, FL 33316-1958 | 2006-01-09 |
| 1073065348 | Stephanie Lauren Banks | Physician Assistant | 1347 S Andrews Ave, Fort Lauderdale, FL 33316 | 2016-11-02 |
| 1255880696 | Jeanette Owens | Physician Assistant | 2307 W Broward Blvd Ste 200, Fort Lauderdale, FL 33312-1420 | 2016-09-27 |
| 1518338391 | Michelle Santamaria | Physician Assistant | 4701 N Federal Hwy, Suite A10, Fort Lauderdale, FL 33308-4608 | 2015-10-19 |
| Find all providers in FORT LAUDERDALE | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33312 |
Please comment or provide details below to improve the information on JENNIFER RIDENOURE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.