Healthcare Provider Details

I. General information

NPI: 1336697663
Provider Name (Legal Business Name): ADA SAIDENSTAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADA SAIDENSTAT ANCC

II. Dates (important events)

Enumeration Date: 09/15/2016
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10301 SW 50TH ST
COOPER CITY FL
33328-4021
US

IV. Provider business mailing address

10301 SW 50TH ST
COOPER CITY FL
33328-4021
US

V. Phone/Fax

Practice location:
  • Phone: 954-260-5066
  • Fax:
Mailing address:
  • Phone: 954-260-5066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9243858
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: