# VENETIAN ISLE MEDICAL OB/GYN CONSULTANTS ,INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558744029
- **Authorized official:** MRS. LYNE RIVERA L.P.N. (OFFICE MANAGER)
- **Authorized official phone:** (954) 456-4888

## Contact information

- **Practice address:** 3001 W HALLANDALE BEACH BLVD, SUITE 200, HALLANDALE, FL 33009-5155
- **Practice address phone:** (954) 456-4888
- **Practice address fax:** (954) 456-9721
- **Mailing address:** 3001 W HALLANDALE BEACH BLVD, SUITE 200, HALLANDALE, FL 33009-5155
- **Mailing address phone:** (954) 456-4888
- **Mailing address fax:** (954) 456-9721

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 367A00000X | Advanced Practice Midwife | ARNP9409101 | FL | Yes |

## Other

- **Enumeration date:** 07/02/2015
- **Last updated:** 07/02/2015