Healthcare Provider Details

I. General information

NPI: 1629436985
Provider Name (Legal Business Name): MADELINE CHERUBIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2016
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 W OAKLAND PARK BLVD STE A5
OAKLAND PARK FL
33311
US

IV. Provider business mailing address

2901 W OAKLAND PARK BLVD STE A5
OAKLAND PARK FL
33311-1236
US

V. Phone/Fax

Practice location:
  • Phone: 954-510-3683
  • Fax:
Mailing address:
  • Phone: 954-510-3683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9276312
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: