Provider Demographics
NPI:1477087104
Name:BELFON, TYSHARRA (MSN FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TYSHARRA
Middle Name:
Last Name:BELFON
Suffix:
Gender:F
Credentials:MSN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1861 SW 101ST WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6531
Mailing Address - Country:US
Mailing Address - Phone:786-412-1150
Mailing Address - Fax:
Practice Address - Street 1:16400 NW 2ND AVE STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6035
Practice Address - Country:US
Practice Address - Phone:305-948-4701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9360419163W00000X
FL11007316363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse