Healthcare Provider Details

I. General information

NPI: 1619558913
Provider Name (Legal Business Name): ROSEMARY ELIZABETH BRAYNEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 N.W. 165TH STREET
MIAMI FL
33169
US

IV. Provider business mailing address

85 N.W. 165TH STREET
MIAMI FL
33169
US

V. Phone/Fax

Practice location:
  • Phone: 954-487-8530
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN2564822
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License NumberRN2564822
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN2564822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: