Individual
LUCEYDIS PERNUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3176 S UNIVERSITY DR, MIRAMAR, FL 33025-3002
(954) 544-2617
Mailing address
948 RAVEN AVE, MIAMI SPRINGS, FL 33166-3835
(786) 333-4096
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11004888
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11004888
FL
Other
Enumeration date
12/08/2019
Last updated
04/13/2023
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