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General NPI Number Information
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NPI Number | 1003782178
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Entity Type | Organization
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Legal Business Name | MEDIVANCE HEALING LLC
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Dates
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Enumeration Date | 10/15/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 220 NW 38TH PL
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City | DEERFIELD BEACH
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State | FL
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Zip | 33064-2715
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Country | US
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Telephone | 786-709-7646
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Fax |
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Provider Business Mailing Address
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Address Line | 220 NW 38TH PL
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City | DEERFIELD BEACH
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State | FL
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Zip | 33064-2715
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | PEDRO MICHAEL CASAS BARON
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Credential |
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Telephone | 786-709-7646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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