Doctor Name: | MS. TATIANA PASSE |
NPI Number: | 1205126745 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 9235770 |
Business Practice Address: | 3001 N State Road 7 Lauderdale Lakes, FL - 333131913 |
Business Phone Number: | 9547337473 |
Business Fax Number: | |
Mailing Address: | 6301 Nw 52nd St, CORAL SPRINGS |
State: | FL |
Postal Code: | 330672150 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/18/2011 |
NPI Last Update Date: | 04/18/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 9235770 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |