1801126115 NPI number — ERIN ADAIR LYDEN ARNP

Table of content: ERIN ADAIR LYDEN ARNP (NPI 1801126115)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801126115 NPI number — ERIN ADAIR LYDEN ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYDEN
Provider First Name:
ERIN
Provider Middle Name:
ADAIR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

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:
1801126115
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9350 SUNSET DR
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33173-3286
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-594-4210
Provider Business Mailing Address Fax Number:
786-594-4300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8940 N KENDALL DR
Provider Second Line Business Practice Location Address:
STE 300E
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33176-2148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-595-2141
Provider Business Practice Location Address Fax Number:
305-279-7778
Provider Enumeration Date:
01/08/2010

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 9266048 , 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)