MEDICARE: JULIAN PARKES REGISTERED NURSE

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	146N00000X	Basic Emergency Medical Technician	EMT540185	FL
2	163W00000X	Registered Nurse	RN9387237	FL

General Provider Information

NPI Number	:	1225417363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIAN PARKES REGISTERED NURSE

Provider Business Mailing Address
First Line	:	500 E BROWARD BLVD
Second Line	:	STE 1710
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33394-3000
Country	:	US
Telephone Number	:	786-529-7362
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 E BROWARD BLVD
Second Line	:	STE 1710
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33394-3000
Country	:	US
Telephone Number	:	786-529-7362
Fax Number	:

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

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	05/21/2015

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