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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477969665 | NPPES |
| Florida | MEDICAID | 141557300 |
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