Healthcare Provider Details

I. General information

NPI: 1174568521
Provider Name (Legal Business Name): ELSIE N SAGUINSIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16555 NW 25TH AVE
OPA LOCKA FL
33054-6583
US

IV. Provider business mailing address

7548 CUTLASS AVE
NORTH BAY VILLAGE FL
33141-4114
US

V. Phone/Fax

Practice location:
  • Phone: 786-466-1732
  • Fax: 305-693-1808
Mailing address:
  • Phone: 305-867-7706
  • Fax: 305-693-1808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1374132
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: