Healthcare Provider Details

I. General information

NPI: 1306507256
Provider Name (Legal Business Name): COURTNEY LEIGH ADAMS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2022
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 JFK DR STE 320
ATLANTIS FL
33462-6641
US

IV. Provider business mailing address

6615 NW 48TH MNR
CORAL SPRINGS FL
33067-2104
US

V. Phone/Fax

Practice location:
  • Phone: 561-548-4900
  • Fax: 561-434-5165
Mailing address:
  • Phone: 239-580-8433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11017191
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: