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General NPI Number Information
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NPI Number | 1548037682
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Entity Type | Individual
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Provider Name | BLIDGIE LIGHTFOOT APRN
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Gender | Female
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Dates
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Enumeration Date | 12/08/2023
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 9111 PARK DR
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City | MIAMI SHORES
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State | FL
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Zip | 33138-3159
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Country | US
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Telephone | 305-756-6110
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Fax |
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Provider Business Mailing Address
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Address Line | 215 NW 33RD LN
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City | POMPANO BEACH
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State | FL
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Zip | 33069-1381
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Country | US
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Telephone | 786-398-3850
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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 | 11013419
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License Number State | FL
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