Healthcare Provider Details

I. General information

NPI: 1700455565
Provider Name (Legal Business Name): SHALINI DEVI SINGH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 W HILLSBORO BLVD STE 207
COCONUT CREEK FL
33073-4397
US

IV. Provider business mailing address

5300 W HILLSBORO BLVD STE 207
COCONUT CREEK FL
33073-4397
US

V. Phone/Fax

Practice location:
  • Phone: 954-570-7644
  • Fax: 954-570-7884
Mailing address:
  • Phone: 954-570-7644
  • Fax: 954-570-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9339984
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06211670
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: