Broadnax, Beverly

Broadnax, Beverly is an sole proprietor health care provider with primary practice located at 2814 Edwards Ave S , Saint Petersburg FL 33705-3653. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Broadnax, Beverly can be contacted via phone (727) 642-6894.

Contact Information

Primary practice address
2814 Edwards Ave S Saint Petersburg FL 33705-3653
Phone: (727) 642-6894
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X PN142291 Florida

Profile Details

NPI number 1477969665
LBN Legal business name Broadnax, Beverly
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 8th, 2014
Last updated Jul 8th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477969665 NPPES
Florida MEDICAID 141557300

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