MEDICARE: MS. MYRLANDE ANSION

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	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1841963584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MYRLANDE ANSION

Provider Business Mailing Address
First Line	:	PO BOX 4932
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33083-4932
Country	:	US
Telephone Number	:	954-662-6501
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 NW 46TH AVE APT 212
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33313-4917
Country	:	US
Telephone Number	:	954-662-6501
Fax Number	:

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

Provider Enumeration Date	:	07/28/2021
Last Update Date	:	07/28/2021

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