=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831203876
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GLORIA CRISTINA CARDOZO ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2006
-----------------------------------------------------
Last Update Date | 12/29/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18501 PINES BOULVARD SUITE 209
-----------------------------------------------------
City | PENBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33029
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-829-8271
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18501 PINES BLVD SUITE 209
-----------------------------------------------------
City | PEMBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33029-1414
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-437-2118
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | ARNP3372362
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------