Healthcare Provider Details

I. General information

NPI: 1285348946
Provider Name (Legal Business Name): SVETLANA PLOTNIKOW APRN, FNP-C, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2023
Last Update Date: 01/09/2023
Certification Date: 01/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19435 SW 25TH CT
MIRAMAR FL
33029-2468
US

IV. Provider business mailing address

19435 SW 25TH CT
MIRAMAR FL
33029-2468
US

V. Phone/Fax

Practice location:
  • Phone: 954-305-7465
  • Fax:
Mailing address:
  • Phone: 954-305-7465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11022719
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: