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NPI Code Detail

MEDICARE: MS. MYRLANDE BANICA RN

MEDICARE: MS. MYRLANDE BANICA RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN9358797FL

General Provider Information

NPI Number : 1194170597
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MYRLANDE BANICA RN
Provider Business Mailing Address
First Line : 9941 THREE LAKES CIR
Second Line :
City : BOCA RATON
State : FL
Zip : 33428-6206
Country : US
Telephone Number : 561-287-0050
Fax Number :
Provider Business Practice Location Address
First Line : 1431 SW 9TH AVE
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-6220
Country : US
Telephone Number : 954-834-5099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2016
Last Update Date : 05/04/2016

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