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NPI Code Detail

MEDICARE: CORIE OPDYKE APRN

MEDICARE: CORIE OPDYKE 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
1363LP0200XPediatric Nurse PractitionerAPRN3075092FL

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 : 1700875523
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORIE OPDYKE APRN
Provider Business Mailing Address
First Line : 900 S PINE ISLAND RD
Second Line : STE 800
City : PLANTATION
State : FL
Zip : 33324-3920
Country : US
Telephone Number : 954-341-0074
Fax Number : 954-345-3474
Provider Business Practice Location Address
First Line : 9120A WILES RD
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33067-1993
Country : US
Telephone Number : 954-341-0074
Fax Number : 954-345-3474
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 11/06/2018

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Directions to “ CORIE OPDYKE APRN” Practice Location

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