Provider Demographics
NPI:1508301714
Name:COMPANIONI, MARIA DE LOURDE (ARNP, PMHNRN-BC, ANP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DE LOURDE
Last Name:COMPANIONI
Suffix:
Gender:F
Credentials:ARNP, PMHNRN-BC, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1400 E OAKLAND PARK BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-4400
Mailing Address - Country:US
Mailing Address - Phone:954-561-6222
Mailing Address - Fax:954-990-7650
Practice Address - Street 1:7369 SHERIDAN ST STE 101
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2776
Practice Address - Country:US
Practice Address - Phone:954-561-6222
Practice Address - Fax:954-990-7650
Is Sole Proprietor?:No
Enumeration Date:2016-12-23
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9352223364SP0808X, 363LP0808X, 364SA2200X, 363LA2200X
FLAPRN9352223363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020142500Medicaid