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General NPI Number Information
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NPI Number | 1851840854
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Entity Type | Individual
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Provider Name | ESTHER ALTIDOR LPN
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Gender | Female
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Dates
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Enumeration Date | 10/02/2016
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Last Update Date | 10/02/2016
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Provider Practice Location Address
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Address Line | 4026 NW 38TH AVE
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33309-4813
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Country | US
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Telephone | 954-268-9044
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Fax |
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Provider Business Mailing Address
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Address Line | 16242 SW 28TH CT
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City | MIRAMAR
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State | FL
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Zip | 33027-5211
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Country | US
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Telephone | 954-682-1173
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 1114201
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License Number State | FL
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