Healthcare Provider Details

I. General information

NPI: 1023988631
Provider Name (Legal Business Name): NURIA VADINE EDOUARD PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5486 BARNSTEAD CIR
LAKE WORTH FL
33463-6673
US

IV. Provider business mailing address

3157 N ALAFAYA TRL
ORLANDO FL
32826-2940
US

V. Phone/Fax

Practice location:
  • Phone: 561-758-5991
  • Fax:
Mailing address:
  • Phone: 239-690-6906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11042994
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: