Healthcare Provider Details

I. General information

NPI: 1255786414
Provider Name (Legal Business Name): ANDRA OPALINSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 OSCEOLA DR
WEST PALM BEACH FL
33409-5038
US

IV. Provider business mailing address

1650 OSCEOLA DR
WEST PALM BEACH FL
33409-5038
US

V. Phone/Fax

Practice location:
  • Phone: 561-803-8880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9226390
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: