Healthcare Provider Details

I. General information

NPI: 1356060073
Provider Name (Legal Business Name): CLARINDA PERDIDO HEFNER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91500 OVERSEAS HWY
TAVERNIER FL
33070-2547
US

IV. Provider business mailing address

91500 OVERSEAS HWY
TAVERNIER FL
33070-2547
US

V. Phone/Fax

Practice location:
  • Phone: 305-434-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11015898
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: