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General NPI Number Information
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NPI Number | 1194538157
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Entity Type | Organization
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Legal Business Name | HOSANNA PRIMARY CARE INC
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 4699 N FEDERAL HWY STE 104
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City | POMPANO BEACH
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State | FL
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Zip | 33064-6510
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Country | US
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Telephone | 954-507-0026
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Fax |
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Provider Business Mailing Address
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Address Line | 2021 NW 69TH TER
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City | MARGATE
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State | FL
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Zip | 33063-2019
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Country | US
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Telephone | 954-507-0026
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Fax | 954-301-7634
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Authorized Official
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Title or Position | OWNER
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Name | GUSTANE PETIT-ALLONCE
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Credential | NP
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Telephone | 954-507-0026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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