Healthcare Provider Details

I. General information

NPI: 1376834366
Provider Name (Legal Business Name): JOSEFINA C ZIADIE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2011
Last Update Date: 04/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 N FLAMINGO RD
PEMBROKE PINES FL
33028-1006
US

IV. Provider business mailing address

1816 NW 182ND AVE
PEMBROKE PINES FL
33029-3019
US

V. Phone/Fax

Practice location:
  • Phone: 954-844-7443
  • Fax:
Mailing address:
  • Phone: 954-610-2494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1458582
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: