Healthcare Provider Details

I. General information

NPI: 1568068385
Provider Name (Legal Business Name): GENEVY RAZON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2020
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 SE 7TH DR
POMPANO BEACH FL
33062-6408
US

IV. Provider business mailing address

2301 SE 7TH DR
POMPANO BEACH FL
33062-6408
US

V. Phone/Fax

Practice location:
  • Phone: 813-944-9906
  • Fax:
Mailing address:
  • Phone: 754-200-0065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF10201290
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: