MEDICARE: GERALDINE HAWKINS 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	261Q00000X	Clinic/Center	ARNP9344375	FL
2	363LF0000X	Family Nurse Practitioner	ARNP9344375	FL

General Provider Information

NPI Number	:	1447706379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALDINE HAWKINS APRN

Provider Business Mailing Address
First Line	:	4161 NW 5TH ST STE 201
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-2101
Country	:	US
Telephone Number	:	954-300-2404
Fax Number	:	954-300-2404

Provider Business Practice Location Address
First Line	:	4161 NW 5TH ST STE 201
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-2101
Country	:	US
Telephone Number	:	954-300-2404
Fax Number	:	954-300-2404

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

Provider Enumeration Date	:	08/31/2016
Last Update Date	:	02/02/2026

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