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NPI Code Detail

MEDICARE: MRS. MIDLAINE RICHARD-PEAN ARNP

MEDICARE:  MRS. MIDLAINE  RICHARD-PEAN  ARNP
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
1363LP2300XPrimary Care Nurse Practitioner9192045FL
2363LF0000XFamily Nurse Practitioner9192045FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164780508
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MIDLAINE RICHARD-PEAN ARNP
Provider Business Mailing Address
First Line : 20613 NW 8TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33169-2380
Country : US
Telephone Number : 786-390-2424
Fax Number :
Provider Business Practice Location Address
First Line : 12401 MIRAMAR PKWY
Second Line :
City : MIRAMAR
State : FL
Zip : 33027-2900
Country : US
Telephone Number : 186-638-9272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2012
Last Update Date : 02/18/2016

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