MEDICARE: LINE BOVERY RN3369722

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	RN3369722	FL

General Provider Information

NPI Number	:	1225985021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINE BOVERY RN3369722

Provider Business Mailing Address
First Line	:	70 NW 49TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33127-2107
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 NW 49TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33127-2107
Country	:	US
Telephone Number	:	305-801-3501
Fax Number	:

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

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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Directions to “ LINE BOVERY RN3369722” Practice Location

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