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NPI Code Detail

MEDICARE: ALTEGRA HEALTH CONNECTIONS, LLC

MEDICARE: ALTEGRA HEALTH CONNECTIONS, LLC
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
1363L00000XNurse Practitioner

General Provider Information

NPI Number : 1154736551
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALTEGRA HEALTH CONNECTIONS, LLC
Provider Business Mailing Address
First Line : 1725 N COMMERCE PKWY
Second Line :
City : WESTON
State : FL
Zip : 33326-3201
Country : US
Telephone Number : 305-779-6070
Fax Number :
Provider Business Practice Location Address
First Line : 1999 BRYAN STREET
Second Line : SUITE 900
City : DALLAS
State : TX
Zip : 75201-3140
Country : US
Telephone Number : 305-779-6070
Fax Number :
Authorized Official
Title or Position : CFO
Name : MICHELE HAAS
Credential :
Telephone Number : 305-779-6070
Provider Enumeration Date : 06/24/2014
Last Update Date : 09/22/2015

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Directions to “ALTEGRA HEALTH CONNECTIONS, LLC ” Practice Location

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