Provider Demographics
NPI:1619526167
Name:VERNET, RAYMONDE
Entity Type:Individual
Prefix:
First Name:RAYMONDE
Middle Name:
Last Name:VERNET
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 1:3060 NE 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6316
Mailing Address - Country:US
Mailing Address - Phone:561-843-5393
Mailing Address - Fax:
Practice Address - Street 1:3400 NW 9TH AVE STE A
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-5948
Practice Address - Country:US
Practice Address - Phone:954-462-4599
Practice Address - Fax:954-530-9597
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-07
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11002157363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11002157OtherAPRN LICENSE NUMBER
FL11002157OtherAPRN LICENSE