Individual
AKILAH A QUALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
4105 PEMBROKE RD, HOLLYWOOD, FL 33021-8103
(954) 265-8100
(954) 985-1411
Mailing address
2900 CORPORATE WAY, DOOR D, MIRAMAR, FL 33025-3925
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP9280857
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016387800
—
FL
Enumeration date
09/16/2014
Last updated
01/16/2020
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