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General NPI Number Information
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NPI Number | 1821747395
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Entity Type | Organization
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Legal Business Name | APRN BENNETT HEALTH CARE , CORPORATION
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 22570 SW 89TH PL
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City | CUTLER BAY
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State | FL
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Zip | 33190-1332
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Country | US
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Telephone | 786-797-8244
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Fax | 786-701-3146
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Provider Business Mailing Address
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Address Line | 22570 SW 89TH PL
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City | CUTLER BAY
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State | FL
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Zip | 33190-1332
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Country | US
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Telephone | 786-797-8244
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Fax | 786-701-3146
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARISOL BENNETT
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Credential | APRN
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Telephone | 786-797-8244
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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 |
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License Number State |
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