Healthcare Provider Details

I. General information

NPI: 1992290001
Provider Name (Legal Business Name): TAMI FIKSTAD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2018
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9611 W BROWARD BLVD
PLANTATION FL
33324-2334
US

IV. Provider business mailing address

9611 W BROWARD BLVD
PLANTATION FL
33324-2334
US

V. Phone/Fax

Practice location:
  • Phone: 954-424-7000
  • Fax:
Mailing address:
  • Phone: 954-424-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1189502
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11023640
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number287645-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: