MEDICARE: KASANDRA ADRAS-CHILDS

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	11018176	FL
2	363LF0000X	Family Nurse Practitioner	11018176	FL

General Provider Information

NPI Number	:	1427704766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASANDRA ADRAS-CHILDS

Provider Business Mailing Address
First Line	:	6505 SW 25TH ST
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-2831
Country	:	US
Telephone Number	:	786-302-2122
Fax Number	:

Provider Business Practice Location Address
First Line	:	6505 SW 25TH ST
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-2831
Country	:	US
Telephone Number	:	786-302-2122
Fax Number	:

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

Provider Enumeration Date	:	02/24/2022
Last Update Date	:	02/11/2026

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