MEDICARE: MRS. VICTORIA AMBROSIO-SLADE MSN, APRN, FNP-BC

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	363LF0000X	Family Nurse Practitioner	11027568	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	:	1598448821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VICTORIA AMBROSIO-SLADE MSN, APRN, FNP-BC

Provider Business Mailing Address
First Line	:	600 S PARK ROAD
Second Line	:	SUITE 400
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021
Country	:	US
Telephone Number	:	954-265-7450
Fax Number	:	954-265-7459

Provider Business Practice Location Address
First Line	:	300 S PARK RD STE 400
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-8353
Country	:	US
Telephone Number	:	954-265-7450
Fax Number	:	954-265-7459

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

Provider Enumeration Date	:	08/11/2023
Last Update Date	:	12/23/2025

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