MEDICARE: SANDRAH CLEOPHAT 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
1	282N00000X	General Acute Care Hospital	650267668	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	9203445	FL
3	363LF0000X	Family Nurse Practitioner	9203445	FL

General Provider Information

NPI Number	:	1174896112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRAH CLEOPHAT ARNP

Provider Business Mailing Address
First Line	:	8403 PINES BLVD # 1369
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-6609
Country	:	US
Telephone Number	:	786-223-5211
Fax Number	:

Provider Business Practice Location Address
First Line	:	8403 PINES BLVD # 1369
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-6609
Country	:	US
Telephone Number	:	786-223-5211
Fax Number	:

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

Provider Enumeration Date	:	02/22/2012
Last Update Date	:	02/05/2025

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