Healthcare Provider Details

I. General information

NPI: 1518553858
Provider Name (Legal Business Name): FAITH HEYWOOD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2020
Last Update Date: 12/20/2020
Certification Date: 12/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20036 NE 2ND CT
MIAMI FL
33179-2937
US

IV. Provider business mailing address

20036 NE 2ND CT
MIAMI FL
33179-2937
US

V. Phone/Fax

Practice location:
  • Phone: 786-303-6026
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN3002152
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: