MEDICARE: SUJAMOL SCARIA 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	363L00000X	Nurse Practitioner	9230243	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	:	1588147227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUJAMOL SCARIA APRN

Provider Business Mailing Address
First Line	:	2900 CORPORATE WAY
Second Line	:	DOOR D
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3925
Country	:	US
Telephone Number	:	954-276-5685
Fax Number	:	954-985-7074

Provider Business Practice Location Address
First Line	:	3501 JOHNSON ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021
Country	:	US
Telephone Number	:	954-265-7750
Fax Number	:	954-276-0280

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

Provider Enumeration Date	:	09/10/2018
Last Update Date	:	12/16/2025

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