MEDICARE: VANESSA S PETIT APRN

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
1	207V00000X	Obstetrics & Gynecology Physician	ARNP9346924	FL
2	363L00000X	Nurse Practitioner	APRN9346924	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295240497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA S PETIT APRN

Provider Business Mailing Address
First Line	:	8261 NW 79TH AVE
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-2822
Country	:	US
Telephone Number	:	305-788-8302
Fax Number	:

Provider Business Practice Location Address
First Line	:	1451 W CYPRESS CREEK RD STE 300
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1953
Country	:	US
Telephone Number	:	305-788-8302
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2017
Last Update Date	:	06/25/2026

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Directions to “ VANESSA S PETIT APRN” Practice Location

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