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NPI Code Detail

MEDICARE: MRS. ILEEN MAUD PRINGLE ARNP

MEDICARE: MRS. ILEEN MAUD PRINGLE 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 Practitioner2248832FL

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 : 1407030992
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ILEEN MAUD PRINGLE ARNP
Provider Business Mailing Address
First Line : 18820 NW 10TH ST
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33029-2925
Country : US
Telephone Number : 954-562-0246
Fax Number :
Provider Business Practice Location Address
First Line : 12401 MIRAMAR PKWY
Second Line :
City : MIRAMAR
State : FL
Zip : 33027-2900
Country : US
Telephone Number : 954-583-8473
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2007
Last Update Date : 04/23/2014

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