Healthcare Provider Details

I. General information

NPI: 1740755537
Provider Name (Legal Business Name): CHELSEA RUTHERFORD APRN- FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA HERMEZ

II. Dates (important events)

Enumeration Date: 10/08/2018
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 GRIFFIN RD STE 205
FT LAUDERDALE FL
33312-6900
US

IV. Provider business mailing address

PO BOX 917770
ORLANDO FL
32891-0001
US

V. Phone/Fax

Practice location:
  • Phone: 305-647-3660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9336934
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: