MEDICARE: PROVIDERS SOLUTIONS CORP

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1326737503
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROVIDERS SOLUTIONS CORP

Provider Business Mailing Address
First Line	:	13268 SW 30TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-7141
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10271 SW 72ND ST STE D102
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3024
Country	:	US
Telephone Number	:	305-928-8845
Fax Number	:	305-928-9846

Authorized Official
Title or Position	:	OWNER
Name	:	ANGELA INFANTAS
Credential	:	APRN
Telephone Number	:	786-488-0858

Provider Enumeration Date	:	05/03/2023
Last Update Date	:	05/03/2023

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