Provider Demographics
NPI:1295369833
Name:PRIORITY HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:PRIORITY HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER(OWNER)
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:RAIKES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:954-665-6766
Mailing Address - Street 1:15901 SW 61ST ST
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3405
Mailing Address - Country:US
Mailing Address - Phone:954-665-6766
Mailing Address - Fax:
Practice Address - Street 1:15901 SW 61ST ST
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33331-3405
Practice Address - Country:US
Practice Address - Phone:954-665-6766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-22
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty