Healthcare Provider Details

I. General information

NPI: 1295109296
Provider Name (Legal Business Name): LIDICE RANKIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2015
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 NW 7TH ST STE 170
MIAMI FL
33126-3425
US

IV. Provider business mailing address

3601 FEDERAL HWY
MIAMI FL
33137-3795
US

V. Phone/Fax

Practice location:
  • Phone: 305-576-6611
  • Fax: 786-476-2813
Mailing address:
  • Phone: 786-442-7704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9387240
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9387240
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: