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General NPI Number Information
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NPI Number | 1346828886
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Entity Type | Organization
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Legal Business Name | DONNA RUSH P.A
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 6980 LONG LEAF DR
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City | PARKLAND
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State | FL
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Zip | 33076-3946
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Country | US
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Telephone | 305-335-0583
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Fax |
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Provider Business Mailing Address
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Address Line | 6980 LONG LEAF DR
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City | PARKLAND
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State | FL
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Zip | 33076-3946
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Country | US
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Telephone | 305-335-0583
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MONIQUE MARTIN
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Credential |
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Telephone | 561-727-6196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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