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General NPI Number Information
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NPI Number | 1497053698
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Entity Type | Individual
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Provider Name | SHUSHANNE SHERVANNESIA WYNTER-MINOTT ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 601 N. FLAMINGO ROAD SUITE 104
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City | PEMBROKE PINES
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State | FL
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Zip | 33065
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Country | US
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Telephone | 954-435-5828
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Fax |
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Provider Business Mailing Address
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Address Line | 17444 SW 47TH CT
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City | MIRAMAR
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State | FL
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Zip | 33029-5056
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Country | US
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Telephone | 305-562-1136
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9212318
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License Number State | FL
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