Healthcare Provider Details

I. General information

NPI: 1477133759
Provider Name (Legal Business Name): MURIELLE CAJUSTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4167 NW 114TH TER
CORAL SPRINGS FL
33065-7173
US

IV. Provider business mailing address

4167 NW 114TH TER
CORAL SPRINGS FL
33065-7173
US

V. Phone/Fax

Practice location:
  • Phone: 954-709-1381
  • Fax:
Mailing address:
  • Phone: 954-709-1381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11005013
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: