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General NPI Number Information
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NPI Number | 1053797670
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Entity Type | Organization
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Legal Business Name | E MED NURSING REGISTRY
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 18350 NW 2ND AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33169
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Country | US
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Telephone | 754-234-0536
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Fax |
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Provider Business Mailing Address
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Address Line | 8280 NE 1ST PL
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City | MIAMI
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State | FL
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Zip | 33138-3748
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Country | US
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Telephone | 754-234-0536
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. PHILLIP THOMPSON
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Credential |
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Telephone | 754-234-0536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 30211788
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License Number State | FL
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