Heart 623 Heart
Nurse Practitioner, Psych/Mental Health in Sunrise, FL. Organization (NPI-2).
Details
- NPI
- 1336730951
- Entity type
- Organization (NPI-2)
- Legal business name
- Heart 623 Heart
- Organization subpart
- No
- Enumeration date
- Jan 27, 2021
- Certification date
- Mar 24, 2025
- Last updated
- Mar 24, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
| 363LF0000X | Nurse Practitioner, Family | – | – |
Practice location
14201 W Sunrise Blvd Ste 208Sunrise, FL 33323-3207
Phone 954-480-3072
Mailing address
4846 N University Dr Ste 612Lauderhill, FL 33351-4510
Phone 954-480-3072
Other practice locations
Gainesville, FL 32601-4154
Phone 954-480-3072
Authorized official
Edlyne Joseph
Pmhnp
9544803072
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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