Provider Demographics
NPI:1134137920
Name:FOSTER, JAMES (ARNP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:FOSTER
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 NE 26TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1416
Mailing Address - Country:US
Mailing Address - Phone:954-495-8490
Mailing Address - Fax:954-495-8592
Practice Address - Street 1:1881 NE 26TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1416
Practice Address - Country:US
Practice Address - Phone:954-495-8490
Practice Address - Fax:954-495-8592
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3182002163WP0809X
FLARNP3182002363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304843801Medicaid
FL304843801Medicaid
FLE8569AMedicare PIN