1225422249 NPI number — DR. ERICH E COMPANIONI MSN,ARNP-BC,FNP,MBA

Table of content: DR. ERICH E COMPANIONI MSN,ARNP-BC,FNP,MBA (NPI 1225422249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225422249 NPI number — DR. ERICH E COMPANIONI MSN,ARNP-BC,FNP,MBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COMPANIONI
Provider First Name:
ERICH
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MSN,ARNP-BC,FNP,MBA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225422249
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/04/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5995 SW 71ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33143-3500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-669-6833
Provider Business Mailing Address Fax Number:
305-666-4030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 PONCE DE LEON BLVD
Provider Second Line Business Practice Location Address:
SUITE 312
Provider Business Practice Location Address City Name:
CORAL GABLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33134-3353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-953-8921
Provider Business Practice Location Address Fax Number:
305-728-2684
Provider Enumeration Date:
03/27/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  ARNP 9389790 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RN9389790 . This is a "FLORIDA NURSING LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: ARNP9389790 . This is a "FLORIDA FAMILY NURSE PRACTITIONER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 116546400 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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