Provider Demographics
NPI:1013639525
Name:CERTI-FI NP PLLC
Entity Type:Organization
Organization Name:CERTI-FI NP PLLC
Other - Org Name:FOREVERBODY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MSN, FNP-BC, AGACNP-BC / TIN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, FNP-BC, AGACNP
Authorized Official - Phone:786-679-5825
Mailing Address - Street 1:4200 NW 16TH ST STE 427
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5899
Mailing Address - Country:US
Mailing Address - Phone:954-298-2823
Mailing Address - Fax:
Practice Address - Street 1:4200 NW 16TH ST STE 427
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-5899
Practice Address - Country:US
Practice Address - Phone:954-303-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-13
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9247990OtherLICENSE NUMBER