MEDICARE: LIDICE RANKIN APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	ARNP9387240	FL
2	363LF0000X	Family Nurse Practitioner	ARNP9387240	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1295109296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIDICE RANKIN APRN

Provider Business Mailing Address
First Line	:	3601 FEDERAL HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33137-3795
Country	:	US
Telephone Number	:	786-442-7704
Fax Number	:

Provider Business Practice Location Address
First Line	:	5040 NW 7TH ST STE 170
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3425
Country	:	US
Telephone Number	:	305-576-6611
Fax Number	:	786-476-2813

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

Provider Enumeration Date	:	11/15/2015
Last Update Date	:	03/31/2026

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Directions to “ LIDICE RANKIN APRN” Practice Location

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