Provider Demographics
NPI:1275209173
Name:TAUREL-GHITELMAN, REBECCA (APRN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:TAUREL-GHITELMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 YACHT CLUB DR APT 609
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3544
Mailing Address - Country:US
Mailing Address - Phone:786-860-0943
Mailing Address - Fax:
Practice Address - Street 1:3610 YACHT CLUB DR APT 609
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3544
Practice Address - Country:US
Practice Address - Phone:786-860-0943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014969363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner