Healthcare Provider Details

I. General information

NPI: 1750498960
Provider Name (Legal Business Name): SHULAMIT C BOSSEWITCH RNC, MSN, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHULAMIT C BOSSEWITCH

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 PINE TREE DR
MIAMI BEACH FL
33140-3931
US

IV. Provider business mailing address

3400 PINE TREE DR
MIAMI BEACH FL
33140-3931
US

V. Phone/Fax

Practice location:
  • Phone: 917-250-6432
  • Fax:
Mailing address:
  • Phone: 917-250-6432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number260036
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN9352811
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: