Healthcare Provider Details

I. General information

NPI: 1295992782
Provider Name (Legal Business Name): DR HEIDY FIRPO PYSD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 12/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12525 ORANGE DR SUITE 706
DAVIE FL
33330-4308
US

IV. Provider business mailing address

12525 ORANGE DR SUITE 706
DAVIE FL
33330-4308
US

V. Phone/Fax

Practice location:
  • Phone: 195-485-4658
  • Fax:
Mailing address:
  • Phone: 195-485-4658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberPY6983
License Number StateFL

VIII. Authorized Official

Name: MRS. HEIDY FIRPO
Title or Position: PRESIDENT
Credential: PYS.D.
Phone: 19548546582