=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669825238
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VICTORIA LYNDSEY CANARELLI APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2016
-----------------------------------------------------
Last Update Date | 02/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3100 WESTON RD
-----------------------------------------------------
City | WESTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33331-3602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-636-8316
-----------------------------------------------------
Fax | 216-636-6036
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 250 S CENTRAL BLVD STE 106
-----------------------------------------------------
City | JUPITER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33458-8812
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-309-4767
-----------------------------------------------------
Fax | 561-678-3556
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | ARNP 9308715
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------