MEDICARE: MRS. FLORENCE ALEXANDRE DESGRAVES 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11001038	FL
2	163WP0808X	Psychiatric/Mental Health Registered Nurse	11001038	FL
3	363LF0000X	Family Nurse Practitioner	APRN11001038	FL
4	163W00000X	Registered Nurse	9251097	FL

General Provider Information

NPI Number	:	1982179057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FLORENCE ALEXANDRE DESGRAVES APRN

Provider Business Mailing Address
First Line	:	8654 S LEXINGTON DR
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-2539
Country	:	US
Telephone Number	:	954-651-1588
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 HOLLYWOOD BLVD STE 715S
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6755
Country	:	US
Telephone Number	:	833-769-3524
Fax Number	:

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

Provider Enumeration Date	:	10/04/2018
Last Update Date	:	01/11/2024

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