MEDICARE: CANDACE KANNIKA ROZIER MONDESIR APRN PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	9298167	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11037500	FL

General Provider Information

NPI Number	:	1013616366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDACE KANNIKA ROZIER MONDESIR APRN PMHNP-BC

Provider Business Mailing Address
First Line	:	8400 N UNIVERSITY DR STE 319
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-1713
Country	:	US
Telephone Number	:	954-539-2366
Fax Number	:

Provider Business Practice Location Address
First Line	:	8400 N UNIVERSITY DR STE 319
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-1713
Country	:	US
Telephone Number	:	954-539-2366
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2023
Last Update Date	:	03/17/2026

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