Provider Demographics
NPI:1659257673
Name:VAYNTRAUB, JANE (LSW)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:
Last Name:VAYNTRAUB
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 S PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2920
Mailing Address - Country:US
Mailing Address - Phone:917-364-1290
Mailing Address - Fax:917-364-1290
Practice Address - Street 1:2707 S PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2920
Practice Address - Country:US
Practice Address - Phone:917-364-1290
Practice Address - Fax:917-364-1290
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2511941171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator