Healthcare Provider Details

I. General information

NPI: 1649880055
Provider Name (Legal Business Name): RONICA SUBRAMONEY PHD, AGACNP, MSN-ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S PARK RD STE 400
HOLLYWOOD FL
33021-8353
US

IV. Provider business mailing address

2900 CORPORATE WAY # D
MIRAMAR FL
33025-3925
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-7450
  • Fax:
Mailing address:
  • Phone: 954-276-5685
  • Fax: 954-985-7074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11008101
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: