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NPI Code Detail

MEDICARE: MISS RITA SEREKE GAIM ARNP

MEDICARE: MISS RITA SEREKE GAIM 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
1363LF0000XFamily Nurse PractitionerAP134682TX
2363LF0000XFamily Nurse Practitioner11017581FL

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 : 1285120873
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS RITA SEREKE GAIM ARNP
Provider Business Mailing Address
First Line : 1081 NW 55TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33127-1829
Country : US
Telephone Number : 954-600-8270
Fax Number :
Provider Business Practice Location Address
First Line : 1685 S STATE ROAD 7 STE 4
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33023-6721
Country : US
Telephone Number : 954-758-4429
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2018
Last Update Date : 11/29/2022

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