Healthcare Provider Details

I. General information

NPI: 1861016412
Provider Name (Legal Business Name): MYRIAM BELIARD MOMPLAISIR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2020
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6437 EGRET TER
COCONUT CREEK FL
33073-2419
US

IV. Provider business mailing address

6437 EGRET TER
COCONUT CREEK FL
33073-2419
US

V. Phone/Fax

Practice location:
  • Phone: 954-675-7788
  • Fax:
Mailing address:
  • Phone: 954-675-7788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11049428
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: