MEDICARE: NICOLETTE ANASTASIA BARBERINI FNP

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	11026693	FL
2	363LF0000X	Family Nurse Practitioner	GAA-NP001822	GA

General Provider Information

NPI Number	:	1962196659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLETTE ANASTASIA BARBERINI FNP

Provider Business Mailing Address
First Line	:	2401 NE 65TH ST APT 312
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-1554
Country	:	US
Telephone Number	:	516-578-5730
Fax Number	:

Provider Business Practice Location Address
First Line	:	6660 ROSWELL RD
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-3167
Country	:	US
Telephone Number	:	404-996-0195
Fax Number	:	404-531-0967

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

Provider Enumeration Date	:	06/06/2023
Last Update Date	:	01/15/2025

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