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General NPI Number Information
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NPI Number | 1568283893
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA PRIMARY HEALTHCARE
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Dates
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Enumeration Date | 10/19/2024
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 8053 W OAKLAND PARK BLVD STE 600
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City | SUNRISE
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State | FL
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Zip | 33351-1159
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Country | US
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Telephone | 786-412-1150
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Fax | 478-202-9585
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Provider Business Mailing Address
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Address Line | 1360 NW 73RD AVE
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City | PLANTATION
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State | FL
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Zip | 33313-5341
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Country | US
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Telephone | 786-412-1150
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TYSHARRA BELFON
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Credential | APRN
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Telephone | 786-412-1150
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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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