Basic Information
| Provider Information | |||||||||
| NPI: | 1326511569 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANDS | ||||||||
| FirstName: | JONI | ||||||||
| MiddleName: | ANNETTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8645 N MILITARY TRL STE 508 | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334106296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616308001 | ||||||||
| FaxNumber: | 5616308007 | ||||||||
| Practice Location | |||||||||
| Address1: | 8645 N MILITARY TRL STE 508 | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334106296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616308001 | ||||||||
| FaxNumber: | 5616308007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2019 | ||||||||
| LastUpdateDate: | 10/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LX0001X | 11000696 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology | 363LX0001X | 22441 | SC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology | 367A00000X | APRN11000696 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.