MEDICARE: FAITH HEYWOOD RN

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	163WG0000X	General Practice Registered Nurse	RN3002152	FL

General Provider Information

NPI Number	:	1518553858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAITH HEYWOOD RN

Provider Business Mailing Address
First Line	:	20036 NE 2ND CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-2937
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20036 NE 2ND CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-2937
Country	:	US
Telephone Number	:	786-303-6026
Fax Number	:

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

Provider Enumeration Date	:	12/20/2020
Last Update Date	:	12/20/2020

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