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General NPI Number Information
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NPI Number | 1770169682
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Entity Type | Individual
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Provider Name | HEINA SIJU ABRAHAM APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/22/2021
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 7501 WILES RD STE 104
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-2063
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Country | US
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Telephone | 954-755-4994
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Fax |
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Provider Business Mailing Address
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Address Line | 2540 RAMPART WAY S
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City | HOLLYWOOD
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State | FL
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Zip | 33026-1360
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Country | US
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Telephone | 954-850-4103
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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 | 11011326
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License Number State | FL
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