Provider Demographics
NPI:1376248443
Name:PARKINSON, VIVIA MELISSA
Entity Type:Individual
Prefix:
First Name:VIVIA
Middle Name:MELISSA
Last Name:PARKINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11220 SW 238TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-3103
Mailing Address - Country:US
Mailing Address - Phone:786-380-1062
Mailing Address - Fax:
Practice Address - Street 1:11220 SW 238TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-3103
Practice Address - Country:US
Practice Address - Phone:786-380-1062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9293775163W00000X
FL11025458363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse